Consulting about insomnia: a method and some preliminary data.

Sleep specialists are increasingly asked to advise other health care workers and patients about specific cases of insomnia, even when the patients do not plan to seek actual treatment of their insomnia at a sleep center. This paper describes a procedure for such one-time consultations. It also provides some preliminary data on the subjective efficacy of such insomnia consultations by reporting data from follow-up telephone calls placed 1, 3 and 12 months after the interview. The patients' estimates of their sleep seemed significantly improved on all three follow-up contacts, and the telephone calls also provided information on what type of recommendations were actually tried by the insomniacs and which ones seemed beneficial. Acceptance of individual sleep hygiene suggestions ranged between 68 percent and 11 percent, but those who tried a given suggestion generally reported its usefulness to be about 70 percent. Advice to seek relaxation or behavioral therapy and suggestions for various medication changes were accepted by about half of those insomniacs who received such advice, and about two-thirds of those who tried them reported them as being helpful. Advice to seek psychotherapy--although quite carefully given--typically was tried by only one-third of those who received it. Overall, the survey shows good patient acceptance of once-only insomnia consultations.