When the possible side-effects of standard treatment (hypnotics) are considered, there is an argument to be made for clinical use of cognitive-behavioural treatments. Research is needed to establish the likely predictors of success with such treatments. As it may well be the case that the treatment efficacy of cognitive-behavioural therapy itself is not durable, the provision of "top-up" ("refresher" sessions of CBT training to improve durability of effect are worthy of investigation.
Countercontrol treatment of sleep-maintenance insomnia in relation to age.
We administered countercontrol behavioral therapy for sleep-maintenance insomnia to 34 insomniacs--ranging in age from 35 to 78 years--in small groups. Twenty-two subjects received immediate and 12 received delayed treatment. Three self-report measures of sleep disruption were collected on daily sleep diaries at baseline, termination of treatment, 1-month follow-up, and 12-month follow-up. Although amount of time awake at night was correlated with age (r = .50), response to treatment was not. Even though older people experienced more time awake after sleep onset prior to treatment, they were able to profit from therapy as well as the younger insomniacs. Countercontrol therapy reduced the sleep complaint for the total group by about 30% at the end of treatment, with gradual improvement continuing through a 4-week follow-up. Nevertheless, it appears that sleep-maintenance insomnia may be more difficult to treat than sleep-onset problems.