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Cognitive Behavioral Therapy Can Help Treat Insomnia

Long term it is more effective without the addition of drugs, study finds

TUESDAY, May 19 (HealthDay News) -- Cognitive behavioral therapy (CBT) can help treat persistent insomnia, working best with medication in acute treatment but on its own over the long term, according to a study published in the May 20 issue of JAMA.

Charles M. Morin, Ph.D., of the Universite Laval in Quebec, and colleagues conducted a trial of 160 adults with persistent insomnia who were treated in two phases. In the first phase they were randomized to receive CBT alone or together with 10 mg/day of zolpidem for six weeks. In the second phase, those in the CBT group either continued or discontinued the therapy for six months, while those in the combined treatment group either continued with both or with CBT alone.

The researchers found that in the first phase of the trial, CBT, whether used on its own or in combination with zolpidem, helped subjects improve sleep latency, sleep efficiency, and time awake after sleep onset. However, during the six-month phase, combined therapy had a higher remission rate than CBT alone, the scientists discovered.

"The best long-term outcome was obtained with patients treated with combined therapy initially, followed by CBT alone," the authors write. "Although the present findings are promising, there is currently no treatment that works for every patient with insomnia and additional studies are needed to develop treatment algorithms to guide practitioners in the clinical management of insomnia."

Morin has served as a consultant to Actelion, Lundbeck, Sanofi-Aventis, Sepracor, and Schering-Plough.

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