Many insomnia patients must make a nightly decision: whether to take a sleeping pill before enduring hours lying awake. Doctors say chronic insomnia can affect your physical and mental health, causing obesity, heart disease and major depression. Now a new study shows that talk therapy does help some people sleep better at night.
For more than a decade Sylvia Bourque had trouble sleeping. She says getting ready for bed was filled with anxiety. "I became very frantic because I was thinking, well, right away, wow, like night is coming again and I will see the ceiling for three or four hours," she said.
Charles Morin of Laval University in Quebec, Canada says there is more than one type of insomnia.
"Some people can have trouble falling asleep at bedtime," he said. "Others have problems with maintaining sleep and still other people just wake up in the morning and they complain of not feeling refreshed."
Morin says finding a long-term treatment for insomnia has been difficult. Many patients become dependent on sleep medications, and they can lose their effectiveness.
So Morin conducted a study of 160 adults with chronic insomnia. For the first six weeks, patients underwent treatment called cognitive behavioral therapy, which helps these patients relax.
At the same time, they took a popular sleep medication called zolpidem. Zolpidem is sold under the brand name Ambien in many parts of the world.
"The most surprising finding was that when you treat insomnia with a combined approach, using both CBT [cognitive behavioral therapy] and medication," Morin said. "You might be tempted to continue this approach over the long term. But what we found here is that after a few weeks, it is best if you discontinue the medication and just continue with CBT."
During the study, participants maintained a routine: their time in bed was limited.
They got up at the same time every day, periodically checked into a sleep laboratory, and kept a diary.
Behavioral therapy was extended for six months.
"If you continue with medication, then people are less likely to invest time and effort in changing their sleep habits," Morin said.
Cognitive behavioral therapy still works for Sylvia Bourque when she wakes up in the middle of the night.
"The next day I will get up and I will be fresh again, and just my attitude changed," Bourque said.
The findings were published in the Journal of the American Medical Association.