Brief counseling sessions treat insomnia up to six months

Older adults with insomnia could improve sleep quality with individualized, brief counseling.

In a randomized controlled study that included 79 older adults with insomnia, researchers from University of Pittsburgh School of Medicine compared the impact of face-to-face and phone counseling to printed educational information about insomnia. They found counseling was effective for helping older adults obtain needed sleep, potentially reducing the need for medications that could cause harm.
The group who received counseling received two sessions from a nurse clinician, followed by two telephone calls that included behavioral instructions for curbing insomnia. The average age of the participants was 71.7 years. In the group, 39 participants received nurse clinician instructions and the other 40 were given printed materials about insomnia and sleep habits.
The groups answered questions about sleep habits, kept diaries, provided demographic information, underwent sleep assessment studies using polysomnography in addition to actigraphy that involves wearing a wrist and ankle monitor.
According to the results, more older adults who received behavioral treatment for insomnia responded favorably - 67 percent versus 25 percent in the control group, after four weeks, reported by the study group. The benefits were noted six months later.
The researchers estimated that for every 2.4 patients counseled, one would no longer meet criteria for insomnia. The study results could ensure safety for older adults who have trouble falling or staying asleep. According to background information from the study, medications are equally as effective, but increase the risk for falls and other adverse events, especially in older populations.
Background information from the study states 15 to 35 percent of older adults in the US suffer from insomnia. Daytime fatigue from poor sleep increases the risk of falls and hip fractures that can lead to disability and hospitalization.
The authors note counseling is an "attractive" option for treating insomnia because it reduces the stigma of behavioral psychological treatments. The authors suggest training could be provided to nurses and other health care professionals who could counsel older patients experiencing insomnia, who were shown in the study to respond favorably.

Insomnia and Anxiety Medications Linked to Increased Mortality

Medications taken for insomnia and anxiety are now linked to increased mortality. Results of an analysis found a 36 percent increased chance of dying among individuals who use sleeping medications and anti-anxiety drugs, found in a twelve year study.
The findings come from a study that followed 14,000 Canadians in the Statistics Canada's National Population Health Survey from 1994 and 2007. During the survey, participants who used drugs for insomnia or anxiety were noted to have a thirty-six percent higher chance of dying after adjusting for other personal factors, including depression, tobacco and alcohol use, other health issues and activity levels.
The researchers say there are several reasons that sleeping pills and medicines to treat anxiety might do more harm than good.

How Sleeping Pills and Anxiety Meds Increase Risk of Dying

Medicines used for insomnia decrease reaction time and alertness and lead to lack of coordination, potentially leading to falls and other mishaps. Impaired judgment could also increase the chances of suicide among depressed patients.
Geneviève Belleville, a professor at Université Laval's School of Psychology where the study was conducted says, "These medications aren't candy, and taking them is far from harmless." Another theory is that insomnia drugs and anxiolytics lead to respiratory depression, aggravating existing breathing problems that can lead to death.
Given the findings, Belleville suggests short-term use of drugs for insomnia and anxiety. Behavioral and cognitive therapy are shown to treat anxiety and sleep disorders and should be offered to patients by physicians. "Combining a pharmacological approach in the short term with psychological treatment is a promising strategy for reducing anxiety and promoting sleep."