Combining Cognitive Behavioral Therapy with a Medication to Treat Insomnia

For people with insomnia, taking a medication can help break the cycle of sleepless nights. And cognitive behavioral therapy can lead to long-lasting improvements with little risk of side effects. But what happens when you combine these two treatments?

A new study helps to answer this question. The results were published today in The Journal of the American Medical Association.

The study involved 160 adults with chronic insomnia. For six weeks they were treated with either CBT or CBT combined with 10 mg of zolpidem at bedtime. Zolpidem is the generic name for Ambien.

Then the study continued for six months. Some of the people treated with only CBT attended monthly treatment sessions; others had no further treatment. Some participants in the combined treatment group continued with CBT and zolpidem; others continued only with CBT.

Results show that for the first six weeks, both CBT and CBT combined with zolpidem reduced insomnia symptoms. About 60 percent of participants in each treatment group slept better. Treatment eliminated insomnia symptoms in 39 percent of the CBT group and 44 percent of the CBT with zolpidem group. The combined treatment also produced a larger increase in total sleep time.

What was the best long-term treatment? CBT with zolpidem for the first six weeks, followed by ongoing CBT without medication. This method eliminated insomnia symptoms in 68 percent of participants.

The study suggests that a combined approach may maximize the strengths of both common insomnia treatments.

You should never take a sleeping pill without first getting approval from your doctor. A sleep specialist at an AASM-accredited sleep center can develop a treatment plan for insomnia that is best for you.