Psychological management of insomnia: A clinical replication series with 100 patients

This study reports on a clinical replications series of 100 patients who presented for insomnia treatment to a university hospital sleep disorders clinic. Treatment consisted of a short-term, structured, and multifaceted intervention combining behavioral, cognitive, educational, and sleep medication withdrawal components. The results from daily sleep diaries showed that patients were sleeping more efficiently after treatment, as evidenced by significant reductions of sleep onset latency, wake after sleep onset, and early morning awakening. The magnitude of improvement obtained on these measures (range=42%–50%) was comparable to those previously obtained in controlled studies of patients with insomnia solicited from the community. Significant reductions in usage of sleep aids were also noted. Despite initial differences in symptom severity, treatment response was comparable across the three most common insomnia subtypes: psychophysiological, drug-dependent, and insomnia associated with psychopathology. These findings suggest that cognitive-behavior therapy is effective in the clinical management of sleep disturbances in a heterogeneous group of insomnia sufferers presenting to a sleep clinic.