Strategies for evaluating adherence to sleep restriction treatment for insomnia

The methodology of assessing adherence to sleep restriction therapy for ins omnia has received little attention in the empirical literature. The presen t study proposes and evaluates several approaches to assessing adherence to sleep restriction. We investigated multiple methods of measuring adherence and tested their utility by determining the strength of their association with treatment outcome in a sample of 22 older adults with insomnia (16 wom en, six men). As a group, the measures indicated reasonably good adherence to treatment recommendations. Time spent in bed was significantly reduced a t post-treatment, and the night to night consistency of time spent in bed a nd arising time was significantly greater at posttreatment. However, time s pent in bed per night at post-treatment still exceeded therapist recommenda tions by a mean of 27.89 min (SD=31.72). Greater consistency of time spent in bed per night and a more consistent arising time predicted a better trea tment outcome. Measures of degree of bedtime reduction did not predict trea tment outcome. (C) 2001 Elsevier Science Ltd. All rights reserved.