Elsevier

Behavior Therapy

Volume 14, Issue 3, June 1983, Pages 424-429
Behavior Therapy

Short-term stimulus control treatment of insomnia in older adults

https://doi.org/10.1016/S0005-7894(83)80104-XGet rights and content

A 4-week stimulus control treatment was administered in small groups to 16 ambulatory, noninstitutionalized older adults with sleep onset insomnia. Nine subjects received immediate treatment, and 7 received delayed treatment. Subjective sleep onset latency was collected at baseline, at termination of treatment, and at a 6-week follow-up. Results showed a strong treatment effect which was replicated with the delayed treatment group; both groups maintained their gains through the 6-week follow-up period. The effectiveness of these procedures with the older insomniac is especially encouraging, since it is a much safer intervention than sedative-hypnotic medications.

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    Stimulus control therapy, another aspect of CBT-I, trains people to associate the bedroom with sleep and re-establish a consistent sleep-wake schedule.19 While there are few studies that specifically look at this one aspect of CBT-I in older adults, one showed maintenance of gains through a 6-week follow-up period.20 The American Association of Sleep Medicine (AASM), considers it an effective and therapy in the treatment of chronic insomnia in the general population.19

  • Cognitive Behavioral Therapy for Insomnia in Older Adults <sup>1</sup>[1]Preparation of this manuscript was supported in part by grants from the National Institute of Mental Health (MH079188) and the Canadian Institutes for Health Research (MT42504).

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    It has been suggested that stimulus control is “one of the most effect single-component treatments” for late-life insomnia.62 This contention is supported by several investigations that report moderate to strong effects of stimulus control on the subjective sleep (sleep-onset latency [SOL] and wake after sleep onset [WASO]) of elders.63–65 Stimulus control does not meet the necessary criteria, however, to be considered an evidence-based treatment for late-life insomnia, primarily because of a lack of research examining the effect of this treatment modality in isolation from other forms of CBTi.59

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    Passive forms of relaxation have been more consistently effective than progressive relaxation for OAWI [45,53,59]. Five studies of stimulus control with older adults show moderate to strong sleep effects on both SOL and WASO [49,54,58–60]. The five studies that have examined sleep restriction or sleep compression [45,52,55,61,62] have shown consistent, strong sleep effects.

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This research was supported in part by BRSG S07 RR07054-17 awarded by the Biomedical Research Grant Program, Division of Research Resources, National Institute of Health, and National Institute on Aging training grant AG00030.

1

The authors would like to express their appreciation to Jeffrey Sugerman for his assistance in this investigation

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