Hypnotic discontinuation in chronic insomnia: Impact of psychological distress, readiness to change, and self-efficacy.
Abstract
OBJECTIVE: To compare individuals who were successful in discontinuing hypnotic medications against those who were not on measures of insomnia severity, medication withdrawal symptoms, psychological symptoms, perceived health, readiness to change and self-efficacy. DESIGN: Secondary analyses of a randomized clinical trial comparing a hypnotic taper intervention with or without self-help treatment for insomnia. MAIN OUTCOME MEASURES: Self-report measures of insomnia severity, medication withdrawal symptoms, depression and anxiety symptoms, physical and mental health, stages of change, readiness to change, decisional balance, and general and situational self-efficacy. RESULTS: There were no significant differences at baseline between medication-free individuals and those still using sleep medication at the end of a taper intervention. Group differences emerged midway through the 8-week withdrawal program and were accentuated after the intervention; participants who remained medication-free during the next six months had less severe insomnia and anxiety symptoms, a more positive perception of their health and higher self-efficacy to refrain from hypnotic use in various situations. Contrary to expectations, there were no differences between drug-free and nondrug-free participants on both readiness to change and stages of change. CONCLUSIONS: Chronic users of hypnotic medications entered a taper intervention with equal levels of psychological distress, health, self-efficacy, and readiness to change. Successful hypnotic discontinuation was associated with overall improvement of insomnia, anxiety and distress symptoms, perceived health and self-efficacy. More intensive and individualized therapeutic attention may be warranted for individuals experiencing worsening of insomnia symptoms, more withdrawal symptoms and psychological distress, and lower self-efficacy during medication discontinuation.
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The population of benzodiazepine patients in the retrieved studies is diagnostically heterogeneous.
“The population of benzodiazepine patients has been described as a “diagnostically heterogenous group,” which aligns with these results [30,36,40,55,59,65,67].”
From Long-term neurological consequences following benzodiazepine exposure: A scoping review (2025) · cites this paper as [55]
In Belleville 2008, those benzodiazepine free for 6 months had less severe insomnia, fewer anxiety symptoms, more positive perception of health, and higher self-efficacy.
“Those BZD free for 6 mo had less severe insomnia, fewer anxiety symptoms, more positive perception of health, and higher self-efficacy”
From Long-term neurological consequences following benzodiazepine exposure: A scoping review (2025) · cites this paper as [55]
The most common indications for benzodiazepine use in the retrieved studies were insomnia, generalized anxiety disorder, and anxiety with or without panic attacks.
“The most common indications for benzodiazepine use in these studies were insomnia [30,36,40,55,59,67], generalized anxiety disorder [32,34,45,50,54,65,68], and anxiety with or without panic attacks [30,36,48,54,59,65]”
From Long-term neurological consequences following benzodiazepine exposure: A scoping review (2025) · cites this paper as [55]
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References 14 · Cited by 41
- Authors
- Belleville, G., & Morin, C. M.
- Affiliations
- Université Laval (CA)
- Venue
- Health Psychology
- Published
- 2008-03
- Volume
- 27
- Issue
- 2
- Pages
- 239-248
- ISSN
- 0278-6133 (ISSN-L)
- 1930-7810
- OpenAlex
- W2081161229
- Cited by
- 41
- References
- 14
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 7 · 2019: 3 · 2018: 3 · 2017: 1 · 2015: 2 · 2014: 2 · 2013: 1 · 2012: 2
- FWCI
- 4.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- chronic insomnia, readiness to change, self-efficacy, psychological distress, anxiety symptoms, depressive symptoms, stages of change, decisional balance, self-help treatment, health perception, sleep medication
- MeSH terms
- Acetamides, Adaptation, Psychological, Adult, Aged, Anxiety, Attitude to Health, Benzodiazepines, Chronic Disease, Combined Modality Therapy, Depression, Female, Follow-Up Studies, Humans, Hypnotics and Sedatives, Individuality, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Motivation, Patient Compliance, Personality Inventory, Piperazines, Pyrimidines, Self Care, Stress, Psychological, Substance Withdrawal Syndrome, Cognitive Behavioral Therapy, Self Efficacy, Azabicyclo Compounds
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