NWO SEM Sleep Society
LITERATURE WATCH

B. Circadian Rhythm Disorders; Insomnia

Sleep 2005:28(10); 1271-78

Sleep 2005; 28: 1319-1327


Phase-Dependent Treatment of Delayed Sleep Phase Syndrome with Melatonin
Sleep 2005:28(10); 1271-78
•        Melatonin, taken in the evening, advances sleep and
circadian phase in patients with DSPS.
•        Subjects were randomly assigned to 1 of 3 treatment
groups. The administration of melatonin (0.3 or 3.0 mg) or
placebo was double-blinded.-;  was administered between 1.5
and 6.5 hours prior to dim light melatonin onset for a 4-week
period.
•        Both doses of melatonin advanced the circadian phase of
endogenous melatonin. The magnitude of phase advance in dim-
light melatonin onset correlated strongly with the time of
melatonin administration, with earlier times being more effective
(r2 = 0.94, P < .0001).

Self-Help Treatment for Insomnia: a Randomized Controlled Trial
Sleep 2005; 28: 1319-1327
•        This study evaluated the efficacy of a self-help behavioral
intervention for insomnia.
•        The study used a 2 (conditions; self-help treatment, no
treatment control) × 3 (assessments; pretreatment, post-
treatment, 6-month follow up) mixed factorial design.
•        One-hundred ninety-two adults (n = 127 women, 65 men;
mean age, 46 years) with insomnia, selected from a larger
community based epidemiologic sample, were randomly
assigned to self-help treatment (n = 96) or no-treatment control
(n = 96).
•        The self-help intervention included 6 educational booklets
mailed weekly to participants and providing information about
insomnia, healthy sleep practices, and behavioral sleep
scheduling and cognitive strategies.
•        Significant but modest improvements were obtained on
subjective sleep parameters for treatment but not control
participants.
•        Treated participants averaged nightly gains of 21 minutes
of sleep and a reduction of 20 minutes of wakefulness, with a
corresponding increase of 4% in sleep efficiency.
•        Improvements were also obtained on measures of
insomnia severity (Insomnia Severity Index) and of sleep quality
(Pittsburgh Sleep Quality Index), and those changes were
maintained at follow-up.
•        A self-help behavioral intervention was effective in
alleviating a broad range of insomnia symptomatology in a
community sample. Self-help may be a promising approach to
make effective intervention more widely available.