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FYI.

Larry NV

Cognitive Behavioral Therapy A Viable Treatment Option For Insomnia

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WESTPORT, CT (Reuters Health) Apr 12 - Study results suggest that cognitive

behavioral therapy (CBT) can be an effective and long-lasting approach for

people with persistent primary insomnia, a form of insomnia characterized by

the inability to stay asleep.

Dr. Jack D. Edinger and colleagues, from the VA Medical Center and Duke

University in Durham, North Carolina, report the finding in the April 11th

issue of The Journal of the American Medical Association.

" Physicians should take home [from this study] the fact that insomnia

patients who have trouble staying asleep through the night can be helped to

sleep better without sleeping pills, " Dr. Edinger told Reuters Health. " Our

cognitive behavioral therapy appears effective for this type of sleep

problem. "

Dr. Edinger's team studied 75 men and women with long-standing persistent

primary insomnia not due to psychiatric, medical or substance abuse

problems. The participants were randomized to cognitive therapy and

strategies designed to improve sleep habits and limit time in bed, to

progressive muscle relaxation training, or to " quasi-desensitization "

treatment.

CBT produced far greater improvements in the majority of outcome measures

than did muscle relaxation training or sham desensitization treatment, the

team reports. " Only the CBT group showed both subjective and objective sleep

time increases through treatment. " These improvements were evident within 6

weeks of treatment and appeared to endure through 6 months of follow-up.

CBT patients enjoyed a 54% reduction in their " wake time after sleep onset "

score, compared with reductions of only 16% and 12% in this key measure in

the relaxation and placebo groups, respectively.

After the trial, " the average CBT recipient reported [using sleep logs] a

middle wake time after sleep onset of less than 30 minutes, a level regarded

as normal, " the researchers note. Neither of the other two groups achieved

this milestone.

JAMA 2001;285:1856-1864.

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