CHANGES IN ATTITUDES TOWARD INSOMNIA FOLLOWING COGNITIVE INTERVENTION AS PART OF A WITHDRAWAL TREATMENT FROM HYPNOTICS

Abstract

This study was designed to investigate the effects of a short-term cognitive-behavioural intervention, as part of a comprehensive medical project of withdrawal from hypnotics, on attitudes toward insomnia. Twenty-four subjects volunteered to participate in a withdrawal project conducted in a sleep clinic for five weeks. All subjects were chronic users of a long-acting hypnotic, and free from other psychotropic drugs. Along with the gradual decrease in hypnotics’ dosage, the programme consisted of sleep evaluations by polysomnography, actigraphic monitoring, daily sleep diaries, and periodical medical examinations. Upon termination of the withdrawal stage, all subjects received a short-term cognitive-behavioural treatment consisting of six sessions and directed at attitude change and correction of misconceptions about sleep and insomnia, and on promoting psychological strategies for coping with the sleep disturbances. Attitudes toward insomnia were measured by the DBAS – Dysfunctional Beliefs and Attitudes about Sleep Scale, administered at three points of time: on the first day of the programme (Time 1), at the termination of the medical withdrawal stage (Time 2), and a week after completion of the short-term cognitive behavioural treatment (Time 3). A multivariate analysis showed a significant effect of the time of measurement on all five subscales of the DBAS. Subsequent analyses indicated that the major change in attitudes was specific to the direct cognitive-behavioural intervention and occurred between Time 2 and Time 3. In follow-ups conducted at 3 and 12 months after completion of the withdrawal project, the majority of the participants (72%) reported refrain from hypnotic use, and regarded the psychological intervention as the major cause of their successful withdrawal from sleeping pills.