Christopher L. Drake, PhDChristopher L. Drake, PhD
In patients with insomnia, intervention with digital cognitive behavioral therapy (dCBT) may help reduce dependence on prescription sleep aids, according to study results presented at SLEEP 2019, June 8-12, in San Antonio, Texas.1

Now recommended as first-line therapy for the treatment of chronic insomnia2, CBT can be administered remotely via the Web or a telemedicine platform, allowing for increased patient access.

In this study, investigators led by Christopher L. Drake, PhD, of Henry Ford Hospital in Detroit, Michigan, randomly assigned 1232 patients with insomnia to either dCBT for insomnia (n=639) or an online sleep education control (n=593). Medication use, both prescription and non-prescription, was evaluated at baseline and post-treatment and was categorized into general classes of medications, including benzodiazepines, hypnotics, and antihistamines.

Results of the mixed-effects logistic regression analysis showed that the odds of using prescription medication were significantly lower in the dCBT group compared with controls following treatment with dCBT (odds ratio 0.09; 95% CI, 0.02-0.34). The investigators noted that while prescription medication use increased from 16.5% to 18% in the control group pre- and post-treatment, medication use decreased in the dCBT arm from 17.8% to 14.6%.

The most significant changes in prescription medication use were recorded for antidepressants and hypnotics; however, no changes in use of nonprescription medications were observed.

In addition to the results suggesting that dCBT may have a positive effect on reducing dependence on prescription sleep aids, the investigators note that dCBT confers an additional advantage over pharmacological therapy in that it is associated with reduced adverse events.

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REFERENCES
1. Drake CL, Cheng P, Tallent G, Atkinson R, Cuamatzi AS, Bazan L. Changes in use of sleep aids following digital cognitive behavioral therapy for insomnia. Presented at: SLEEP 2019. June 8-12, 2019; San Antonio, TX. Abstract 0366.
2. Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD. Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016;165(2):125-133. doi: 10.7326/M15-2175