SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science III. Sleep Disorders – Insomnia
py. The present study evaluated the efficacy of a combined treatment of
cognitive-behaviour therapy and evening bright light therapy.
Methods: One-hundred and nine adults (n= 48 male, mean age=63.91,
SD=6.47) with sleep maintenance and/or early morning awakening insomnia
were selected from community-based sample. Participants were
randomly allocated to receive either a four-week, group-based treatment
program of cognitive-behaviour therapy and evening bright light
therapy (n=42)(CBT+EBL), cognitive-behaviour therapy alone (n=37)
(CBT only) or to a wait-list control condition (n=30). The efficacy of the
therapy program was assessed using one-week sleep diaries, actigraphy
and a comprehensive battery of questionnaires to evaluate quality of life
and other psychological variables. All participants completed these outcome
measures at pre-treatment, post-treatment, and 3-month followup.
Participants allocated to the treatments groups (CBT+EBL and CBT
only) also completed these measures at 6-month follow-up.
Results: Participants in the treatment groups (CBT+EBL and CBT only)
had significantly less wake after sleep onset and higher sleep efficiency,
when compared to waitlist at post-treatment and 3-month follow-up.
Treated participants averaged a reduction of 78 minutes of wakefulness
from pre-therapy to post-therapy. This improvement corresponded
with a gain of 17% in sleep efficiency from pre-therapy to post-therapy.
These improvements were maintained at 3-month follow-up. Following
treatment, participants also reported a significant reduction in insomnia
severity and fatigue relative to the wait-list group. Results indicate outcomes
related to sleep quality and quantity, psychological variables, and
daytime functioning, do not differ between the two treatment groups.
Potential explanations for this finding will be discussed and other outcome
data will be presented.
Conclusion: A four-week program of cognitive behaviour therapy with
or without evening bright light is an effective treatment for sleep maintenance
and early morning awakening insomnia in the older population.
Support (If Any): NHMRC
0507
GREATER TOTAL SLEEP TIME IS ASSOCIATED WITH
LOWER PRE-SLEEP SALIVARY CORTISOL DURING
CHRONIC ZOLPIDEM USE
Dasgupta R 1,2 , Randall S 1 , Roehrs T 1 , Harris E 1 , Maan R 1 , Roth T 1,2
1
Sleep Disorders & Research Center, Henry Ford Health System,
Detroit, MI, USA, 2 Psychiatry & Behavioral Neuroscience, Wayne
State University School of Medicine, Detroit, MI, USA
Introduction: Some studies have reported enhanced nocturnal cortisol
levels in insomniacs. The question arises as to whether insomnia treatment
impacts cortisol levels. We evaluated the relation of pre-sleep salivary
cortisol to total sleep time during chronic zolpidem use.
Methods: Individuals 21-70 years old (N=39) met DSM IV-TR criteria
for primary insomnia. Participants additionally had a sleep efficiency of