EFFECTIVENESS OF A BEHAVIORAL GROUP TREAT MENT IN PATIENTS WITH PRIMARY INSOMNIAS

Behavioral intervention programs are gaining importance in the treatme nt of primary insomnia. After an overview of assessment, classificatio n and models of the origins and maintenance of this disorder,studies o n the effectiveness of multicomponent behavioral group treatments are discussed and results of an own study evaluating such a group program for primary insomnia patients are presented. The intervention comprise d 12 sessions and consisted of sleep education, stimulus control train ing and the improvement of sleep hygiene, relaxation training, problem solving as well as an enhancement of daily structure and activities. To evaluate the effectiveness of the program, subjective sleep-specifi c measures (e.g. sleep quality, sleep onset latency, total sleep time, sleep-related cognitions) as well as non-specific variables (trait an xiety. depression, general well-being) were assessed before and immedi ately after therapy using rating scales and sleep diaries. In addition , polysomnographic variables were obtained before and three months aft er the intervention. The sample consisted of 13 patients in the therap y group and 7 patients in a waiting list control group. The behavioral intervention program produced relevant improvements of the subjective ly perceived sleep. These were demonstrated in an increased sleep qual ity, a reduced sleep onset latency, a reduced usage of sleep medicatio n and more functional cognitions relating to sleep. No significant imp rovements were attained in objective sleep parameters. The results rep resent further evidence of the effectiveness of behavioral interventio ns for primary insomnia, although these are rarely implemented in clin ical practice. Results are discussed with special regard to the agreem ent between various data sources.