Evaluation of short-term nonpharmacological treatment of insomnia in a clinical setting.

Of the 86 chronic insomnia patients we treated with nonpharmacological means, 74 improved considerably. The subjective improvement was confirmed by the outcome of the sleep logs registered after 4 weeks of treatment (decrease in sleep-onset latency, wake after sleep onset, and an increase of sleep efficiency). Of the 49 patients who had used hypnotics at intake, 18 discontinued their medication and 19 considerably reduced theirs after therapy. The investigated population was characterized by high scores for anxiety, depression, and somaticization; the depression and anxiety scores were significantly higher for the hypnotics users. The percentage of nonresponders (patients who were unaffected by the treatment) was highest for the group of homemakers and for the group of patients with a low level of education. Significantly less of the nonresponders had received cognitive therapy compared with responders. The value of nonpharmacological treatment lies in the fact that it leads to a subjective improvement of sleep and to increased control over the sleep problem that the patient was experiencing. Helping the patients to obtain control over their sleep problems was our main therapeutic goal.