EVIDENCE LIBRARY
Small Internet-CBT Trial Added Behavioral Treatment After Persistent Insomnia Under Hypnotics
An exploratory trial found improved subjective sleep with internet CBT added to usual care. It did not test a universal replacement for benzodiazepines.
An exploratory trial found improved subjective sleep with internet CBT added to usual care. It did not test a universal replacement for benzodiazepines.
The comparison
Twenty-three patients remained symptomatic after pharmacologic insomnia treatment, including benzodiazepines. They were randomized to usual care or usual care plus a six-week computerized CBT program.
The combined group showed greater improvement in the primary sleep questionnaire and several secondary outcomes. No adverse events were reported during the small study.
Addition and measurement
Usual care continued, so the comparison was an add-on strategy rather than behavioral treatment versus no medication. Subjective diaries and questionnaires were not equivalent to polysomnographic measurements.
There was no psychological placebo controlling attention or expectations, the sample was small, and one-year durability was unavailable. The findings support studying behavioral support when symptoms persist. They cannot establish a benzodiazepine discontinuation rate, prove long-term freedom from insomnia, or show that every patient who did not respond to a hypnotic will benefit equally.
Source paper
Original analysis of the supplied journal article, identified as PMC6482403.