Jan. 3, 2024 – Learning techniques to improve sleep or taking the medication Ambien were similarly effective at improving daytime functioning in people with insomnia, according to a new study in the journal JAMA Psychiatry.
Insomnia is a common sleep disorder, and its symptoms can include trouble falling asleep, trouble staying asleep, or poor quality sleep. People with insomnia typically experience daytime sleepiness.
Most people who seek treatment for insomnia do so because the condition impacts their ability to function normally during the day, the researchers noted. Their study was designed to examine whether behavioral therapy or a common medication therapy was better than the other when it came to improving daytime functioning. A second phase of the study looked at whether adding a second type of treatment resulted in better daytime functioning among people whose insomnia didn’t improve from just medication or from just therapy.
For the study, 211 adults in the U.S. and Canada with chronic insomnia were randomly assigned to either take the drug zolpidem, which is sold under the brand name Ambien, or to participate in behavioral therapy where they learn to limit the amount of time they spend in bed as well as limit the activities they do in bed. The average age of people in the study was 46 years old, and 63% of them were women.
Chronic insomnia was defined as occurring three or more nights per week, and people in the study reported having trouble falling asleep or staying asleep for more than one month.
Both the Ambien and the therapy group experienced similar improvement in daytime outcomes, including a reduction in depression symptoms, reduced fatigue, and overall better mental health and functioning. The therapy group reported more improvement in anxiety symptoms than the Ambien group.
The authors suggested that the therapy group may have experienced reduced anxiety because the people in the study fell asleep faster and spent less time awake in the middle of the night, which may have “reduced anxiety and worry when initiating sleep and during midnight awakenings,” the researchers wrote.
“In addition, [behavioral therapy] may also reduce sleep-related anxiety or distress through modifying participants’ perception of sleep,” they noted.
In a second phase of the study, those whose insomnia didn’t improve in the first phase were randomly assigned to an additional insomnia therapy, such as Ambien, behavioral therapy, another medication called trazodone, or another therapy called cognitive behavioral therapy. Adding a second treatment resulted in further improvements in those people's daytime functioning.
The improved functioning and mental health of the people in the study continued during a 12-month follow-up period, the authors noted.
As many as 1 in 3 adults have insomnia symptoms, and about 10% of people meet the criteria to be diagnosed with an insomnia disorder, according to Cleveland Clinic.
The authors noted that further research is needed to confirm the findings due to some study limitations, such as not having a control group as part of the study design.
