Discontinuation of hypnotics during cognitive behavioural therapy for insomnia.docVIP

BMC Psychiatry BioMedCentral Research article Open Access Discontinuation of hypnotics during cognitive behavioural therapy for insomnia Lucie Zavesicka*?1,2, Martin Brunovsky?1,2, Milos Matousek?1 and Peter Sos?1,2 Address: 1Prague Psychiatric Center, Ustavni 91, 18103 Prague 8, Czech Republic and 23rd Faculty of Medicine, Charles University, 100 00 Prague 10, Czech Republic Email: Lucie Zavesicka* - zavesicka@pcp.lf3.cuni.cz; Martin Brunovsky - brunovsky@pcp.lf3.cuni.cz; Milos Matousek - matousek@pcp.lf3.cuni.cz; Peter Sos - sos@pcp.lf3.cuni.cz * Corresponding author ?Equal contributors Published: 18 September 2008 Received: 14 September 2007 Accepted: 18 September 2008 BMC Psychiatry 2008, 8:80 doi:10.1186/1471-244X-8-80 This article is available from: /1471-244X/8/80 ? 2008 Zavesicka et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: In practical sleep medicine, therapists face the question of whether or not to discontinue the ongoing use of hypnotics in patients, as well as the possible effects of discontinuation. The aim of this study was to evaluate the effects of discontinuing third-generation hypnotics on the results of cognitive-behavioural therapy (CBT) for primary insomnia in patients after long-term abuse. Methods: Twenty-eight outpatients were treated by CBT for 8 weeks. The treatment outcome was estimated by means of differences among subjective clinical scales and polysomnography variables assessed before and after the treatment period. The therapeutic effect in a subgroup of 15 patients who had previously received hypnotics and were successively withdrawn during weeks 2–6 was compared to the effect achieved in patients who had