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CBT added to tapering helped patients with chronic insomnia discontinue benzodiazepine use

Clinical impact ratings GP/FP/Primary care Mental Health

Key Words: benzodiazepines • cognitive therapy • sleep initiation and maintenance disorders

The first 150 words of the full text of this article appear below.

METHODS
Design: randomised controlled trial.

Allocation: {allocation concealed^*}.

Blinding: blinded (technician who scored polysomnography sleep stages).^*

Follow up period: 12 months

Setting: a research based sleep clinic in a university hospital in Sainte-Foy, Québec, Canada.

Patients: 76 patients 55 years of age (mean age 63 y, 50% women) with chronic insomnia (for 6 months), impaired daytime functioning or mood disturbances, and benzodiazepine use (on >50% of nights) for 3 months. Exclusion criteria included medical or psychiatric disorders known to cause insomnia, sleep apnoea, periodic limb movements during sleep and other psychiatric disorders or cognitive impairment.

Intervention: 10 weeks of CT (n = 27), CBT (n = 24), or SMT (n = 25). SMT in both CT and SMT alone groups aimed for dosage reductions of 25% at 2 week intervals until the lowest available dose of the BDP was reached. CBT (10 ninety minute weekly sessions) was designed to reinforce . . . [Full text of this article]

Patrick G O’Malley, MD, MPH, FACP

Walter Reed Army Medical Center
Washington, DC, USA