Late-Life Insomnia: Brief Behavioral Treatment

Effects of a Brief Behavioral Treatment for Late-Life Insomnia: Preliminary Findings

Anne Germain, Ph.D.; Douglas E. Moul, M.D., M.P.H.; Peter L. Franzen, Ph.D.; Jean M. Miewald, B.A.; Charles F. Reynolds, III, M.D.; Timothy H. Monk, Ph.D., D.Sc.; Daniel J. Buysse, M.D.
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA

Study Objectives: Insomnia is a chronic and prevalent sleep disorder in adults older than 65 years. Hypnotics raise safety concerns in this group, and standard behavioral treatments are time consuming. This preliminary report addresses the effects of a brief behavioral treatment for insomnia in older adults who present with the typical psychiatric and medical comorbidities of aging.

Methods: Thirty-five older adults (10 men, 25 women, mean age = 70.2 ± 6.4 years old) were randomly assigned to a brief behavioral treatment for insomnia (BBTI; n = 17) or to an information-only control (IC; n = 18) condition. All subjects completed clinician-administered and self-report measures of sleep quality, as well as a sleep diary, at baseline. Interventions were delivered in a single individual session with a booster session administered 2 weeks later. Postintervention assessments were completed after 4 weeks.

Results: Significant improvements in self-report and sleep diary measures and mild-to-moderate improvement in anxiety and depression were observed after treatment in participants randomly assigned to BBTI, as compared with participants randomly assigned to IC. At posttreatment assessment, 12 BBTI participants (71%) and 7 IC participants (39%) met criteria for response. Nine BBTI participants (53%) met criteria for remission, whereas, in the IC group, 3 participants (17%) met the criteria.

Conclusion: BBTI was associated with significant improvements in sleep measures and in daytime symptoms of anxiety and depression. BBTI appears to be a promising intervention for older adults with insomnia.

Journal of Clinical Sleep Medicine VOL. 2, №4, OCTOBER 15, 2006, p. 407-408
American Academy of Sleep Medicine