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Treatment Preference and Patient Satisfaction in Chronic Insomnia
Abstract
STUDY OBJECTIVES: The purposes of this study were to examine treatment preference and satisfaction with group treatment in individual with chronic insomnia. DESIGN: Correlational. SETTING: The study was conducted in an outpatient hospital setting. PATIENTS OR PARTICIPANTS: Participants were 43 adult volunteers from the community. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Prior to treatment, participants were presented with descriptions of behavioral and pharmacological treatment for the problem of insomnia and asked to rate the acceptability, presumed effectiveness, and presumed side-effects of treatment. A sub-sample of these individuals (n = 37) participated in a 6-week cognitive behavioral treatment group for insomnia. Sleep diary and questionnaire data were collected prior to and following treatment. Results showed that cognitive-behavioral therapy was significantly preferred over pharmacological therapy at pre-treatment and that more favorable assessments of cognitive-behavioral therapy at pre-treatment were associated with better adherence but not improved outcome. Of treatment techniques, participants least liked sleep restriction and most liked sleep hygiene. Results indicated that more favorable ratings of the usefulness of sleep restriction were associated with improvements in sleep efficiency, sleep-related impairment, and quality of life. CONCLUSIONS: Implications of these findings are that patient preference is important to assess prior to treating insomnia and that more work may be needed to increase patients' awareness of the benefits of sleep restriction.
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“The latter is specifically important for most patients who prefer nonpharmacological treatments for depression [91] and insomnia [92].”
From The effects of exercise on sleep in unipolar depression: a systematic review and network meta-analysis (2021) · cites this paper as [92]
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Psychological and Behavioral Treatments for Insomnia II
Edinger, J. D., Leggett, M. K., Carney, C. E., & Manber, R. (2016) · Elsevier eBooks · doi:10.1016/b978-0-323-24288-2.00086-6 · Cited by 17
On the brain disease model of mental disorders.
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Veterans’ experiences with and perspectives on insomnia treatment: A qualitative study.
Bramoweth, A. D., Rodriguez, K. L., Klima, G. J., Appelt, C. J., & Chinman, M. (2020) · Psychological Services · doi:10.1037/ser0000494 · Cited by 16
Cho, H. J., Kremer, S., & Young, J. (2021) · Current Sleep Medicine Reports · doi:10.1007/s40675-021-00220-3 · Cited by 15
The relationship of primary health care use with persistence of insomnia: a prospective cohort study
Hayward, R., Jordan, K., & Croft, P. (2012) · BMC Family Practice · doi:10.1186/1471-2296-13-8 · Cited by 16
“This may bear testament to the fact that no treatment is both effective and without side effects, although cognitive behavioural therapy and the melatonin agonist ramelteon appear promising [7,8,15-18].”
BackgroundPoorebrahim, A., Lin, C., Imani, V., Griffiths, M. D., & Pakpour, A. H. (2020) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-020-00287-z · Cited by 13
A Novel Group Cognitive Behavioral Therapy Approach to Adult Non-rapid Eye Movement Parasomnias
O'Regan, D., Nesbitt, A., Biabani, N., Drakatos, P., Selsick, H., Leschziner, G. D., Steier, J., Birdseye, A., Duncan, I., Higgins, S., et al. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.679272 · Cited by 12
“Where once medication-only treatments were favored, there has recently been a paradigm shift toward CBT-based interventions, which are viewed more favorably by patients (26), and treatment guidelines (27).”
BackgroundBrief behavioral treatment for insomnia decreases trauma-related nightmare frequency in veterans
Ranney, R. M., Gloria, R., Metzler, T. J., Huggins, J., Neylan, T. C., & Maguen, S. (2022) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.10002 · Cited by 14
“16 Notably, patients with comorbid PTSD and insomnia have been shown to benefit from CBT-I, with treatment leading to reductions in both insomnia severity and PTSD severity.”
Nazem, S., Barnes, S. M., Forster, J. E., Hostetter, T. A., Monteith, L. L., Kramer, E. B., Gaeddert, L. A., & Brenner, L. A. (2023) · JMIR Mental Health · doi:10.2196/50516 · Cited by 15
“Veterans have an interest in digital health technologies, including internet-delivered CBT-I (iCBT-I), and leveraging technology is critical to meeting treatment demand and patient preferences [20-24].”
Zao Ren An Shen capsule for insomnia: a double-blind, randomized, placebo-controlled trial
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Revisiting the relationship between wages and sleep duration: The role of insomnia
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“Patients who suffer from psychological disturbances prefer non-pharmacological approaches [40,41].”
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“For example, Vincent and Lionberg [7] reported that at pretreatment in an outpatient hospital setting in Canada, CBT was significantly preferred over pharmacological therapy by 43 participants based on overall acceptability ratings.”
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“Many patients prefer non-pharmacological approaches (Vincent and Lionberg, 2001).”
Nazem, S., Sun, S., Barnes, S. M., Monteith, L. L., Hostetter, T. A., Forster, J. E., Brenner, L. A., Galfalvy, H., & Haghighi, F. G. (2024) · Translational Behavioral Medicine · doi:10.1093/tbm/ibae032 · Cited by 12
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Benzodiazepine usage and patient preference for alternative therapies: A descriptive study
Sake, F., WONG, K. K. H., Bartlett, D. J., & Saini, B. (2019) · Health Science Reports · doi:10.1002/hsr2.116 · Cited by 11
“Interestingly, participants with sleep problems in this study were more likely to prefer behavioural treatment, which supports and further extends previous research.(74,75) These patients can be specifically targeted for behavioural intervention in primary care settings.”
Result‘Folk Theories’ About the Causes of Insomnia
Harvey, A. G., Soehner, A. M., Lombrozo, T., Bélanger, L., Rifkin, J. B., & Morin, C. M. (2013) · Cognitive Therapy and Research · doi:10.1007/s10608-013-9543-2 · Cited by 10
“We also know that patients with insomnia are more likely to prefer a psychological treatment over a biological treatment (Morin et al. 1992; Vincent and Lionberg 2001).”
BackgroundResultKim, J. H., & Oh, P. J. (2016) · Korean Journal of Adult Nursing · doi:10.7475/kjan.2016.28.1.13 · Cited by 11
“선행연구에서 비 약물적 중재종류별 효과를 제시한 연구가 없어 비교하기는 어 려우나 국외의 수면중재에 대한 메타분석연구는 행동치료가 약물치료에 비해 좋은 효과를 보였다고 보고한 바 있고[19,20] 인지행동중재 중 자극조절요법과 수면제한 치료가 가장 효과 적인 행동치료 개입이라고 보고하였다[21,22].”
Denis, D., Eley, T. C., Rijsdijk, F. V., Zavos, H. M. S., Keers, R., Espie, C. A., Luik, A. I., Badini, I., Derveeuw, S., Romero, A., et al. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-017177 · Cited by 9
“…interventions to treat insomnia such as CBT-I have been rated highly by patients with regards to how acceptable they find the treatment, 27 28 it is important for this study to investigate whether participants who do not necessarily have a sleep disorder find CBT-I an acceptable…”
Brupbacher, G., Straus, D., Porschke, H., Zander-Schellenberg, T., Gerber, M., von Känel, R., & Schmidt‐Trucksäss, A. (2019) · Trials · doi:10.1186/s13063-019-3415-3 · Cited by 11
Osteoporosis Medication Profile Preference: Results from the PREFER-US Study
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Zao Ren An Shen capsule for chronic insomnia
Birling, Y., Bensoussan, A., Sarris, J. J., Avard, N., & Zhu, X. (2019) · Medicine · doi:10.1097/md.0000000000014853 · Cited by 10
“Unsurprisingly, insomniacs have a preference for nonpharmacological approaches.([23,24]) Cognitive Behavioral Therapy for Insomnia (CBT-I), a set of psychotherapeutic interventions used specifically to treat insomnia disorder, has been proposed as an alternative.”
BackgroundDai, N., Li, Y., Sun, J., Li, F., & Xiong, H. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.537402 · Cited by 10
“Unsurprisingly, most insomnia patients have a preference to nonpharmacological interventions (46, 47).”
BackgroundCognitive-Behavioral Therapy for Insomnia (CBT-I)
Bennett, D. S. (2020) · Springer eBooks · doi:10.1007/978-3-030-44447-1_3 · Cited by 9
Treatment Modality Preferences and Adherence to Group Treatment for Panic Disorder with Agoraphobia
Perreault, M., Julien, D., White, N. D., Bélanger, C., Marchand, A., Katerelos, T. E., & Milton, D. (2013) · Psychiatric Quarterly · doi:10.1007/s11126-013-9275-1 · Cited by 9
New models of care for psychology in Canada's health services.
Graff, L. A., Kaoukis, G., Vincent, N., Piotrowski, A. S., & Ediger, J. P. (2012) · Canadian Psychology/Psychologie canadienne · doi:10.1037/a0026635 · Cited by 10
Self-citationGervais, C., Hjeij, D., Fernández‐Puerta, L., & Arbour, C. (2024) · Brain Injury · doi:10.1080/02699052.2024.2318599 · Cited by 9
“This is unfortunate as CBT is often preferred by patients dealing with insomnia to drug therapy (74).”
BackgroundPrimary Insomnia: An Overview of Practical Management Using Cognitive Behavioral Techniques
Espie, C. A., & Kyle, S. D. (2009) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2009.07.009 · Cited by 8
Looman, M. I., Schoenmakers, T. M., Blanken, T. F., Linnebank, F. E., Kamphuis, J. H., & Lancee, J. (2024) · Journal of Behavioral and Cognitive Therapy · doi:10.1016/j.jbct.2024.100499 · Cited by 7
“An effective stand-alone ACT-I protocol is of specific clinical interest, as it would offer a distinct alternative for patients who do not prefer or respond well to sleep restriction or stimulus con-trol (Kyle et al., 2011; Vincent & Lionberg, 2001).”
Li, M., Wang, B., Chen, Q., Gao, D., & Zang, Y. (2021) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2021.100729 · Cited by 7
“Many individuals with insomnia exhibited preferences for non-pharmaceutic and self-help interventions [17].”
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Ibrahim, S., & Sidani, S. (2013) · Health · doi:10.4236/health.2013.511240 · Cited by 7
“Three studies have examined acceptability and preference of behavioral treatments for managing chronic insomnia for Veterans [15] and adults [13,14].”
BackgroundResultInfluentialZhu, X., Tao, M., Hu, H., Gao, J., Chen, J., Lu, T., Wang, X., Kong, W., Lv, L., & Wei, M. (2022) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2022/5867523 · Cited by 6
“When it comes to the nonpharmacological approach, cognitive behavioral therapy for insomnia (CBT-I) has been proven to be efective and recommended as the frst-line treatment for insomnia.”
BackgroundMaurer, L., Aust, F., & Lorenz, N. (2023) · Somnologie - Schlafforschung und Schlafmedizin · doi:10.1007/s11818-023-00422-7 · Cited by 6
Initial Sleep Time Predicts Success in Manual-Guided Cognitive Behavioral Therapy for Insomnia
Bothelius, K., Kyhle, K., Broman, J., Gordh, T., & Fredrikson, M. (2015) · Behavioral Sleep Medicine · doi:10.1080/15402002.2015.1007995 · Cited by 6
“For example, sleep restriction is an effective (Morin et al., 2006) but disliked (Vincent & Lionberg, 2001) treatment intervention.”
BackgroundCognitive Behavioral and Psychological Therapies for Chronic Insomnia
Espie, C. A., & Kyle, S. D. (2011) · Elsevier eBooks · doi:10.1016/b978-1-4377-1703-7.10012-x · Cited by 6
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Exercise therapy in the application of sleep disorders
Zhao, Y., Dai, Q., Li, Y., & Li, C. (2024) · Frontiers in Neurology · doi:10.3389/fneur.2024.1324112 · Cited by 8
Jernelöv, S., Rosén, A., Forsell, E., Blom, K., Ivanova, E., Maurex, L., Jansson‐Fröjmark, M., Åkerstedt, T., & Kaldo, V. (2025) · SLEEP · doi:10.1093/sleep/zsaf093 · Cited by 5
“Third, there is evidence suggesting that sleep restriction therapy might be the least palatable treatment component in CBT-I [11].”
Validation of the Insomnia Treatment Acceptability Scale (ITAS) in Primary Care
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“Vincent and Lionberg (2001) used the ITAS to examine patient satisfaction among 43 respondents to a newspaper advertisement offering behavioral treatment for chronic insomnia.”
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“More recently, Vincent and Lionberg (2001) found that most individuals presenting for group CBT–”
BackgroundComorbid Insomnia and Sleep Disordered Breathing
Glidewell, R. N. (2013) · Current Treatment Options in Neurology · doi:10.1007/s11940-013-0259-0 · Cited by 5
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Exploring the Contribution of Treatment Factors to Preferences for Smoking Cessation Interventions
Sidani, S. (2016) · International Archives of Nursing and Health Care · doi:10.23937/2469-5823/1510028 · Cited by 4
“The favorable perception of behavioral therapy for smoking cessation is comparable to the general tendency to view non-pharmacological interventions as more acceptable than pharmacological ones for the management of psychological problems such as depression [30,31] and insomnia [32].”
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One size does not fit all: matching patients with insomnia treatment modality
Cvengros, J. A. (2014) · Sleep Medicine · doi:10.1016/j.sleep.2013.12.002 · Cited by 4
“More positive beliefs about treatment usefulness are associated with increased treatment satisfaction and improvements in insomnia symptoms [9].”
BackgroundOnline treatment of insomnia using behavioral techniques
Hofman, W. F., & Kumar, A. (2010) · UvA-DARE (University of Amsterdam) · Cited by 4
Improved sleep as an adjunctive treatment for smoking cessation
Patterson, F., & Ashare, R. L. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-815373-4.00022-8 · Cited by 5
The efficacy of homoeopathic simillimum in the treatment of chronic primary insomnia
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“According to Vincent and Lionberg (2001) patients prefer psychological treatment over pharmacological treatment for chronic insomnia.”
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Cognitive behavioural therapy for anxiety disorders and insomnia: a commentary on future directions
Aho, K. M., Pickett, S. M., & Hamill, T. S. (2014) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x14000117 · Cited by 3
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Barriers to nonpharmacologic treatments for stress, anxiety, and insomnia
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Combined Chronotherapy for Poor Sleep Following Acute Coronary Syndrome: A Pilot Randomized Trial
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“Furthermore, patients with sleep problems without psychiatric disorders prefer non-pharmacological interventions rather than pharmacological therapy [6] due to fewer side effects, long-term effectiveness, and better ability to maintain daytime functions [7].”
The misprescribing of Z-drugs for insomnia
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“치료 요소는 보 통 자극조절(stimulus control), 수면제한(sleep restriction), 이완요법(relaxation therapy), 수면위생교육(sleep hygiene), 인지요법(cognitive therapy) 등이 포함되어 있 으며 그 중 수면제한과 자극조절이 치료효과가 좋은 것으로 보고되고 있다.(12,13) 수면제한은 Spielman 등(14)이 1987년에 소개한 요법으로 실제 잠을 잘 수 있는 시간만큼만 잠자리 에 누워있을 수 있도록 수면을 취할 수 있는 시간을 제한시 켜 수면일정을 정해주면 수면기회가 줄어드는 만큼 수면에 대한…”
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“…and educational level, current use of sleep medication, physical functioning, depression, fatigue severity, or dysfunctional beliefs and attitudes about sleep (Bluestein et al. 2011; Cheung et al. 2018; Perez et al. 2022; Sidani, Miranda, Epstein, Bootzin, et al. 2009; Vincent and Lionberg 2001).”
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“People with insomnia tend to prefer psychological approaches over pharmacological ones, which often leads to better adherence [59, 60].”
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Participants' preferences for HIV prevention interventions.
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Short-Term and Group Treatment Approaches
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Manber, R., & Ong, J. C. (2016) · doi:10.3109/9781420080803-14
Carney, C. E. (2002) · doi:10.31390/gradschool_dissertations.564
“Satisfaction with treatment is not a trivial matter, as it affects adherence and dropout rates (Vincent & Lionberg, 2001).”
BackgroundBilişsel Davranışçı Terapi-Uykusuzluk Protokolü ve Etkililik Çalışmalarının Gözden Geçirilmesi
Çıvgın, U., & Di̇ri̇k, G. (2020) · Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry · doi:10.18863/pgy.557227 · Cited by 2
Poirot, I., Brion, A., Schroder, C. M., & Touitou, Y. (2016) · Dunod eBooks · doi:10.3917/dunod.schro.2016.01.0089 · Cited by 1
Jin, D., Zhang, J., Zhang, Y., An, X., Zhao, S., Duan, L., Zhang, Y., Zhong, Z., Lian, F., & Tong, X. (2020) · Research Square · doi:10.21203/rs.3.rs-122890/v1
Sandoval-Rincón, M., Sánchez‐Ferrer, J. C., Muñóz-Delgado, J., Saldívar-Hernández, R. K., & Jiménez‐Genchi, A. (2020) · doi:10.21203/rs.3.rs-28124/v1
“Sleep hygiene is probably the most popular behavioral insomnia approach and some studies have found that patients prefer it to other therapies [24].”
BackgroundPrevalence of Sleep Disturbance and correlates in Chinese Older Adults with type 2 diabetesPreprint
Gong, Y.-X., Hou, C., Wang, S., Wang, F., Huang, Z., Yang, J.-J., & Jia, F. (2021) · Research Square · doi:10.21203/rs.3.rs-886317/v1
Metadata
- Authors
- Vincent, N., & Lionberg, C.
- Affiliations
- University of Manitoba (CA)
- Corresponding author
- Vincent, Norah
- ORCID
- Vincent, Norah
- Venue
- SLEEP
- Publisher
- Oxford University Press (OUP)
- Published
- 2001-06
- Volume
- 24
- Issue
- 4
- Pages
- 411-417
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- OpenAlex
- W2418847208
- Cited by
- 221
- References
- 0
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 7 · 2023: 13 · 2022: 10 · 2021: 13 · 2020: 17 · 2019: 11 · 2018: 7 · 2017: 6 · 2016: 11 · 2015: 11 · 2014: 10 · 2013: 9 · 2012: 10
- FWCI
- 7.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- SLEEP (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- chronic insomnia, treatment preferences, patient satisfaction, cognitive behavioral therapy for insomnia, group therapy, sleep restriction, sleep hygiene, pharmacotherapy, medication adherence, sleep efficiency, quality of life
- MeSH terms
- Adult, Attitude to Health, Choice Behavior, Chronic Disease, Humans, Sleep Initiation and Maintenance Disorders, Middle Aged, Cognitive Behavioral Therapy, Patient Satisfaction
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