Article Critique of Efficacy of Two Behavioural Treatment Programs for Comorbid Geriatric Insomnia - Rybarczyk Et Al 2002

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Rybarczyk, B., Lopez, M., Benson, R., Alsten, C., & Stepanski, E. (2002). Efficacy of two behavioural treatment programs for comorbid geriatric insomnia. Psychology and Aging, 17(2), 288-298.
Rybarczyk et al. (2002) found that the literature addressing geriatric insomnia provides evidence of the efficacy of several behavioural treatments, but that most research with this population has excluded those with comorbid medical illness. Thirty-eight geriatric patients with comorbid insomnia and medical illness participated in this randomised controlled trial, which allocated them to either cognitive-behavioural treatment (CBT), home-based audio relaxation treatment (HART), or delayed-treatment control conditions using stratified random allocation.
Seven self-rate or self-report and one actigraphy measures assessed between- and within-group differences at pre-treatment, post-treatment, and 4-month follow-up. The CBT included weekly group sessions with behavioural and cognitive components, relaxation training, and sleep hygiene education. The HART participants received audiotape recordings with four relaxation and sleep-training programmes and a guidebook with behavioural components. Control participants completed the same interval assessments as the treatment groups and were offered HART at the end of 6 months.
The study found differential improvement between the CBT and control groups at post-treatment and follow-up on five of seven sleep measures and a clinically significant difference for sleep efficiency between the HART and control groups at post-treatment. It concluded that CBT is an effective treatment for comorbid geriatric insomnia. Home-based treatment should, however, still be considered as a less-expensive alternative, as it did show some benefit.
The hypotheses are that behavioural treatments are effective for individuals with comorbid geriatric…...

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