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.