Insomnia is usually defined as subjective complaints of poor sleep accompanied by impairment in daytime function. It is common in people aged older than 55 years (9 percent-25 percent are affected) and is associated with reduced quality of life, depression, and more physician visits. Despite these links to individuals' lives and societal costs, most people with chronic insomniaup to 85 percentremain untreated, according to background information in the article. Two-thirds of individuals with insomnia report having poor knowledge of available treatment options, and as many as one fifth resort to either untested over-the-counter medications or alcohol in attempts to improve their condition. Among primary care physicians, the treatment of choice for insomnia has commonly been prescription medication. Cognitive behavioral therapy (CBT) is the most widely used psychological intervention for insomnia. No studies have compared the newer non-benzodiazepine sleep medications with nonpharmacological treatments.

Borge Sivertsen, Psy.D., of the University of Bergen, Norway, and colleagues conducted a randomized controlled trial between January 2004 and December 2005 to compare the short- and long-term clinical efficacy of CBT and the non-benzodiazepine sleep medication zopiclone. The trial included 46 adults (average age 60.8 years; 22 women) with chronic primary insomnia. The participants received either the CBT intervention (information on sleep hygiene, sleep restriction, stimulus control, cognitive therapy, and progressive relaxation technique; n = 18), sleep medication (7.5 mg zopiclone each night; n = 16), or placebo medication (n = 12). All treatment duration was 6 weeks, and the 2 active tre
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Contact: Borge Sivertsen, PsyD
borge.sivertsen@psykp.uib.no
JAMA and Archives Journals
27-Jun-2006