[Comparative study of effectiveness of cognitive-behavior therapy and zopiclone for chronic insomnia]. 2017

P V Pchelina, and A A Tabidze, and M G Poluektov
Sechenov First Moscow State Medical University, Moscow, Russia.

Chronic insomnia is a widespread and therapy resistant sleep disorder associated with multiple diseases and worsening of its course. Cognitive-behavior therapy of insomnia (CBT-I) is a pathogenetically based method of chronic insomnia treatment. 42 patients (male 14, female 28, age from 29 to 80) matched ICSD-3 criteria of chronic insomnia participated in the crossover study including 2-week courses of treatment by CBT-I and Zopiclone. All participants underwent polysomnography. Effectiveness of treatment was evaluated by questionnaires: Insomnia severity index (ISI), Pittsburgh sleep quality index, Beck depression inventory, Disfunctional beliefs about sleep, Sleep hygiene index. Treatment with CBT-I and zopiclone produced simular improvement of sleep quality with Insomnia severity index decreased to 3,6 (from 17,7±5,3 to 12,8±5,1) and 4,9 (from 16,5±5,8 to 12,9±6,2) respectively (р<0,05) while after two weeks of stopping treatment the significant difference remained only for CBT-I comparing with zopiclone treatment (12,9±6,2 and 15,5±4,6 points by ISI respectively) (p<0,05). The use of CBT-I leads to decrease of level of depression from 11,8±6,9 to 8,5±7, Sleep hygiene index decreases from 26,9±7,5 to 23,9±5,7 and disfunctional beliefs about sleep level drops from 104,9±29,7 to 84,4±34,2 (all these differences were significant at p<0,05). Analysis of the characteristics of responders and nonresponders has shown that the mean age of the first ones was younger comparing with nonresponders (40,5±12,9 and 57,2±11,7, p<0,05 respectively) that allows us to consider young age as predictor of CBT-I effectiveness. Treatment of chronic insomnia by CBT-I has simular efficacy as pharmacotherapy, but additionally it leads to the emprovement of emotional state and its therapeutistic effects after discontinuation lasts longer.

UI MeSH Term Description Entries
D006993 Hypnotics and Sedatives Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety. Hypnotic,Sedative,Sedative and Hypnotic,Sedatives,Hypnotic Effect,Hypnotic Effects,Hypnotics,Sedative Effect,Sedative Effects,Sedatives and Hypnotics,Effect, Hypnotic,Effect, Sedative,Effects, Hypnotic,Effects, Sedative,Hypnotic and Sedative
D007319 Sleep Initiation and Maintenance Disorders Disorders characterized by impairment of the ability to initiate or maintain sleep. This may occur as a primary disorder or in association with another medical or psychiatric condition. Disorders of Initiating and Maintaining Sleep,Insomnia,Sleeplessness,Chronic Insomnia,DIMS (Disorders of Initiating and Maintaining Sleep),Early Awakening,Insomnia Disorder,Nonorganic Insomnia,Primary Insomnia,Psychophysiological Insomnia,Rebound Insomnia,Secondary Insomnia,Sleep Initiation Dysfunction,Transient Insomnia,Awakening, Early,Dysfunction, Sleep Initiation,Dysfunctions, Sleep Initiation,Insomnia Disorders,Insomnia, Chronic,Insomnia, Nonorganic,Insomnia, Primary,Insomnia, Psychophysiological,Insomnia, Rebound,Insomnia, Secondary,Insomnia, Transient,Insomnias,Sleep Initiation Dysfunctions
D008297 Male Males
D010879 Piperazines Compounds that are derived from PIPERAZINE.
D003071 Cognition Intellectual or mental process whereby an organism obtains knowledge. Cognitive Function,Cognitions,Cognitive Functions,Function, Cognitive,Functions, Cognitive
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015928 Cognitive Behavioral Therapy A directive form of psychotherapy based on the interpretation of situations (cognitive structure of experiences) that determine how an individual feels and behaves. It is based on the premise that cognition, the process of acquiring knowledge and forming beliefs, is a primary determinant of mood and behavior. The therapy uses behavioral and verbal techniques to identify and correct negative thinking that is at the root of the aberrant behavior. Behavior Therapy, Cognitive,Cognitive Behaviour Therapy,Cognitive Therapy,Psychotherapy, Cognitive,Cognition Therapy,Cognitive Behavior Therapy,Cognitive Psychotherapy,Therapy, Cognition,Therapy, Cognitive,Therapy, Cognitive Behavior,Behavior Therapies, Cognitive,Behavioral Therapies, Cognitive,Behavioral Therapy, Cognitive,Behaviour Therapies, Cognitive,Behaviour Therapy, Cognitive,Cognition Therapies,Cognitive Behavior Therapies,Cognitive Behavioral Therapies,Cognitive Behaviour Therapies,Cognitive Psychotherapies,Cognitive Therapies,Psychotherapies, Cognitive,Therapies, Cognition,Therapies, Cognitive,Therapies, Cognitive Behavior,Therapies, Cognitive Behavioral,Therapies, Cognitive Behaviour,Therapy, Cognitive Behavioral,Therapy, Cognitive Behaviour
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D053961 Azabicyclo Compounds Bicyclic bridged compounds that contain a nitrogen which has three bonds. The nomenclature indicates the number of atoms in each path around the rings, such as [2.2.2] for three equal length paths. Some members are TROPANES and BETA LACTAMS. Azabicyclo(1.1.0)Butanes,Azabicyclo(2.2.2)Octanes,Azabicyclo(3.3.1)Nonanes,Azabicyclo(4.3.0)Nonanes,Azabicyclo(5.2.2)Undecanes

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