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Can't sleep? Try the couch

A brief behavioural therapy, consisting of two in-person sessions and two phone calls, could improve sleep in older adults with insomnia, according to a new study.

Daniel J Buysse of the University of Pittsburgh School of Medicine and colleagues conducted a randomised clinical trial of a brief behavioural treatment involving 79 elder adults, with an average age of about 72, with insomnia.

The 39 patients in the treatment group received four sessions of individualised behavioural counselling from a nurse clinician. Two sessions were conducted in person and two by phone. The other 40 in the information control group received only general printed educational material about insomnia and sleep habits.

Based on questionnaires and sleep diaries, the researchers found that more patients in the behavioural treatment group responded favourably to the treatment by the end of four weeks (67 per cent versus 25 per cent) or no longer had insomnia (55 per cent versus 13 per cent). They said that the results suggested that for every 2.4 patients treated with the counselling therapy, one would respond favourably and one would no longer have insomnia.

Improvements were maintained at the six-month follow-up. “Although brief behavioural treatment for insomnia shares many features with other behavioural insomnia treatments, some particular features make it an especially attractive option,” said the researchers.

They said the strong behavioural focus might reduce patient concerns about ‘psychological’ treatments. Also, the programme can be taught to nurses in a short period of time.

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