Relaxation Better Than Drugs For Insomnia

By Michael Smith,
MedPage Today Staff Writer

Relaxation and other behavioral techniques may overcome insomnia better than drugs, found investigators here.

A randomized, placebo-controlled trial comparing the hypnotic agent Imovane (zopiclone) with cognitive behavioral therapy found that for most outcomes, Imovane was no more effective than placebo, the researchers reported in the June 28 issue of the Journal of the American Medical Association.

On the other hand, cognitive behavioral therapy was significantly better than either, said Børge Sivertsen, Psy.D., of the University of Bergen, and colleagues.

Imovane is not approved in the U.S., although Lunesta (eszopiclone)—a version of the medication containing only the active isomer—was approved in 2004.

In older adults with chronic primary insomnia, "cognitive behavioral therapy was more effective immediately and long-term compared with both zopiclone and placebo," Dr. Sivertsen and colleagues concluded. However, they noted, the finding might not generalize to all sleep medications.

Despite that limitation, they argued, the results imply that physicians should be cautious in prescribing hypnotics for long-term use, given increasing evidence of the long-term efficacy of cognitive behavioral therapy and the lack of similar evidence for the medications. "Clinicians," they wrote, "should consider prescribing hypnotics only for acute insomnia."

CLICK HERE TO READ THE FULL STORY