A randomized controlled trial comparing sleep hygiene advice with a self-help book focusing on cognitive behavioral therapy for insomnia: a study among patients with prescribed hypnotics from the GP.
Bjørn Bjorvatn, Ragnhild Stokke Lundetræ, Øystein Vedaa et al.
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In 30 seconds
This randomized controlled trial compared a cognitive behavioral therapy for insomnia (CBTi) self-help book with written sleep hygiene advice among patients recently prescribed zopiclone or zolpidem by their general practitioner. At 4–5 months, daily hypnotic use fell in the book group from 25.4% to 18.6%, while it rose in the sleep hygiene group from 21.2% to 22.7%. Analyses favored the book for hypnotic use and anxiety. Insomnia symptoms decreased in both groups, and depression was unchanged.
Key findings
- Daily hypnotic use declined from 25.4% to 18.6% with the self-help book, compared with an increase from 21.2% to 22.7% with sleep hygiene advice.
- Reported anxiety fell from 32.1% to 23.2% in the book group and rose from 27.0% to 31.7% in the sleep hygiene group.
- Insomnia symptoms decreased in both groups; depression remained unchanged.
Why it matters
The findings suggest that a CBTi-based self-help resource may offer a low-threshold approach for patients using prescribed hypnotics, with potential benefits for hypnotic use and anxiety. The comparison also indicates that sleep hygiene advice alone may not produce the same pattern of change. These results are relevant to efforts to address insomnia and hypnotic use in general practice.
What to keep in mind
Follow-up was limited to 4–5 months, and outcomes were assessed by online questionnaire. The abstract reports follow-up data for 125 participants but does not provide longer-term outcomes.