Sleep Restriction Therapy Effective in Insomnia

A UK pragmatic, superiority, open label, randomized controlled trial of sleep restriction therapy (SRT) versus sleep hygiene concluded that brief primary care nurse delivered SRT is both clinically effective and cost-effective in treating insomnia disorder and improving other aspects of mental health and functioning. A total of 642 participants (mean age 55·4 years, 76·2% female, 97·2% White) were randomly assigned to four sessions of nurse delivered SRT plus a sleep hygiene booklet or sleep hygiene booklet only between August 2018, and March 2020. At 6 months follow up, mean insomnia severity index score was 10·9 for SRT and 13·9 for sleep hygiene, indicating reduction in insomnia severity in the SRT group. There was strong evidence of commensurate improvements in depressive symptoms and mental health-related quality of life, but less evidence of an effect on physical health-related quality of life. Work-related productivity and general activity impairment, self-reported sleep, and sleep-related quality of life were also improved at all timepoints. There were no serious adverse events related to intervention. The findings are in line with previous studies. By systematically restricting and regularizing time in bed to improve sleep, SRT is a key component of cognitive behavioral therapy, the first-line treatment of insomnia, which counters behaviors that perpetuate insomnia, specifically time-in-bed extension, variability in sleep–wake timing, and daytime napping. Source: https://www.thelancet.com/