Brief behavior therapy helps older insomniacs

A recent study has found that older adults suffering from insomnia may find it easier to sleep following brief behavioral therapy in which they learn about mechanisms of sleep, factors that influence sleep, and behaviors that promote or interfere with sleep.

Pennsylvania sleep specialists found that 12 of 17 elderly insomniacs, or 71%, that took part in a single behavioral therapy session and a booster session slept better and had less anxiety and depression. Nine subjects (53%) met criteria for remission of insomnia following the treatment.

In contrast, only 7 of 18 participants (39%) that were assigned to an “information-only” control group saw any improvement in sleep and reduction in anxiety and depression, and only three (17%) met criteria for remission of insomnia.

Dr. Daniel J. Buysse and colleagues from the University of Pittsburgh School of Medicine noted that insomnia is a “chronic and prevalent” problem in adults over 65. Buysse et al said hypnotics could help but that the drugs “raise safety concerns” in the elderly and standard behavioral therapy is time consuming, with standard programs given over a period of 6 to 8 weeks.
The brief behavioral therapy intervention (BBTI) developed by the Pittsburgh researchers comprises a single, 45-minute educational session with a follow-up 30-minute booster session two weeks later. During the sessions, a nurse gives advice on getting to sleep and staying asleep that is tailored to the individual patients. For example, subjects are encouraged not to go to bed until sleepy and not to stay in bed unless asleep and to get up at the same time every day.

Buysse said he and his colleagues “tried to identify the active elements from treatments that have been previously described and kind of boil them down into just the basics so that we could present a treatment to people quickly, give them specific recommendations on how they might change their behavior to improve their sleep and it seems to be promising.”

The researchers went on to report that the “BBTI group showed large improvements in overall sleep quality, sleep latency, wake time after sleep onset, and sleep efficiency as well as marked reductions in depression and small changes in anxiety, whereas the information-only control group did not.”

The impact the BBTI had on sleep improvements was comparable with those reported for traditional longer behavioral and cognitive-behavioral interventions for insomnia, they wrote. The results were reported in the Journal of Clinical Sleep Medicine.

© Copyright 2007 Insight Journal Online Magazine.

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