Brief counseling aids older adults’ insomnia

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Insomnia is a common problem for older adults, but even a couple sessions of behavior counseling can help them sleep easier, new research suggests.

In a study of 35 older adults, who were an average of 70 years old, with long-standing insomnia, researchers found that those who received two counseling sessions on healthy sleep habits were resting better four weeks later.

Half of the subjects, which included 25 women and 10 men, were randomly assigned to the short-term treatment, while the other half acted as the comparison group.

Overall, 12 out of 17 patients reported improvements in their sleep quality, versus 7 out of 18 study participants who received the kind of care typically offered in primary care settings—including pamphlets on sleep and insomnia, and a phone call from a nurse.

The findings, published in the Journal of Clinical Sleep Medicine, are in line with past studies that have shown behavioral therapy to be very effective for chronic insomnia. Indeed, other researchers have argued that counseling should be the first treatment choice rather than sleep medication, which can cause side effects or dependence.

But behavioral therapy with a specialist can be time-consuming, and not always readily available, the authors of the new study note in their report.

So it’s important to see whether even brief counseling in a primary care office can be effective, according to Dr. Anne Germain and her colleagues at the University of Pittsburgh in Pennsylvania.

In their study, the counseled patients had one 45-minute session with a nurse practitioner, followed by a shorter “booster” session two weeks later.

During the sessions, they learned about the factors that either promote or interfere with sleep, and received specific advice on sound sleeping—going to bed only when sleepy, for example, and getting up when you can’t fall asleep or stay asleep.

Four weeks later, the study found, nearly three quarters of these patients had some improvement in their sleep quality. In more than half, the insomnia was considered to be in remission. In contrast, only 17 percent of patients who received standard therapy had improvement in sleep quality.

Larger, longer studies are needed to see if the benefits of this short-term treatment last and if they hold true for people with various medical conditions that affect sleep, the researchers note.

“Nevertheless,” they conclude, “the present preliminary findings are encouraging and suggest that (brief behavioral therapy) may be amenable to use in primary care settings.”

SOURCE: Journal of Clinical Sleep Medicine, October 1, 2006. 

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