Publications internationales Sequential combinations of drug and cognitive behavioral therapy for chronic insomnia: An exploratory study

Sequential combinations of drug and cognitive behavioral therapy for chronic insomnia: An exploratory study

Annie Vallières, Charles M. Morin and Bernard Guay

Revue : Behaviour Research and Therapy

a-École de psychologie, Université Laval, Pavillon FAS, Québec, Canada G1K 7P4
b-Centre de recherche Université Laval-Robert Giffard, Québec, Canada G1J 2G3

Received 8 June 2004; revised 3 November 2004; accepted 5 November 2004. Available online 11 February 2005.




Abstract
This study explores the efficacy of sequential treatments involving medication and cognitive behavioral treatment (CBT) for primary insomnia. Seventeen participants took part in a multiple baseline design and were assigned to: (a) medication for 5 weeks, followed by combined medication plus CBT for 5 weeks; (b) combined treatment for 5 weeks, followed by CBT alone; or (c) CBT alone. Each treatment sequence produced significant sleep improvements, but at different points in time. For the first sequence, most of the sleep improvement was obtained after the introduction of CBT, while for the other sequence and CBT alone, improvement appeared during the first weeks. These results suggest that sleep improvement seems affected by the way treatments are combined. Also, a sequence beginning with a combined treatment followed by CBT alone seems to produce the best outcome. Additional research should be conducted with larger samples to determine the most effective sequence.

Keywords: Combined treatment; Insomnia; Cognitive-behavior therapy; Sequential treatment; Single case study

Behaviour Research and Therapy - Volume 43, Issue 12 - Pages 1611-1630

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