Preferences for behavioral therapies for chronic insomnia


Purpose: The purpose of this study was twofold: to examine the acceptability and preference for the two behavioral therapies, and to identify factors persons with chronic insomnia take into account when choosing treatment. Methods: The data were obtained in a large trial evaluating the effects of Stimulus Control and Sleep Restriction therapies. Prior to treatment, participants completed the treatment acceptability and preference (TAP) questionnaire, which described the Stimulus Control Therapy and the Sleep Restriction Therapy and requested participants to rate the acceptability of each treatment option before choosing one for the management of chronic insomnia. Open-ended questions were used to explore the factors that participants considered when making a choice. Results: Participants rated the Sleep Restriction Therapy as acceptable and 70.2% of participants preferred it over Stimulus Control Therapy. The factors that influenced participants’ choice related to the familiarity, previous personal experience, novelty, and suitability of the treatment. Conclusion: Persons have expressed a preference for treatments to manage chronic insomnia. Healthcare providers are in a position to provide relevant information about treatment options in order to help persons make informed treatment related decisions.

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Ibrahim, S. and Sidani, S. (2013) Preferences for behavioral therapies for chronic insomnia. Health, 5, 1784-1790. doi: 10.4236/health.2013.511240.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Bain, K.T. (2006) Management of chronic insomnia in elderly persons. The American Journal of Geriatric Pharmacotherapy, 4, 168-192.
[2] Morin, C. and Benca, R. (2012) Chronic insomnia. The Lancet, 379, 1129-1141.
[3] Morin, C.M. and Espie, C.A. (2003) Insomnia: A clinical guide to assessment and treatment. Kluwer Academic/ Plenum, New York.
[4] Edinger, J.D. and Carney, C.E. (2008) Overcoming insomnia: A cognitive-behavioral therapy approach-therapist guide. Oxford University Press, New York.
[5] Murtagh, D.R. and Greenwood, K.M. (1995) Identifying effective psychological treatments for insomnia: A metaanalysis. Journal of Consulting and Clinical Psychology, 63, 79-89.
[6] Morin, C.M., Culbert, J.P. and Schwartz, S.M. (1994) Nonpharmacological interventions for insomnia: A meta-analysis of treatment efficacy. American Journal of Psychiatry, 151, 1172-1180.
[7] Smith, M.T., Perlis, M.L., Park, A., Smith, M.S., Pennington, J., Giles, D.E. and Buysse, D.J. (2002) Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia. American Journal of Psychiatry, 159, 5-11.
[8] Morin, C.M., Hauri, P.J., Espie, C.A., Spielman, A.J., Buysse, D.J. and Bootzin, R.R. (1999) Nonpharmacologic treatment of chronic insomnia. An American academy of sleep medicine review. Sleep, 22, 1134-1156.
[9] Irwin, M.R., Cole, J.C. and Nicassio, P.M. (2006) Comparative meta-analysis of behavioral interventions for insomnia and their efficacy in middle-aged adults and in older adults 55+ years of age. Health Psychology, 25, 3-14.
[10] McCurry, S.M., Logsdon, R.G., Teri, L., and Vitiello, M.V. (2007) Evidence-based psychological treatments for insomnia in older adults. Psychology and Aging, 22, 18-27.
[11] Morin, C.M., Bootzin, R.R., Buysse, D.J., Edinger, J.D., Espie, C.A. and Lichstein, K.L. (2006) Psychological and behavioral treatment of insomnia: Update of the recent evidence (1998-2004). Sleep, 29, 1398-1414.
[12] Morgenthaler, T., Kramer, M., Alessi, C., Friedman, L. and Boehlecke, B. (2006) Practice parameters for the psychological and behavioral treatment of insomnia: An update. Sleep, 29, 1415-1419.
[13] Vincent, N. and Lionberg, C. (2001) Treatment preference and patient satisfaction in chronic insomnia. Journal of Sleep and Sleep Disorders Research, 24, 411-417.
[14] Morin, C.M., Gaulier, B., Barry, T. and Kowatch, R.A. (1992) Patients’ acceptance of psychological and pharmacological therapies for insomnia. Sleep, 15, 302-305.
[15] Epstein, D.R., Babcock-Parziale, J.L., Haynes, P.L. and Herb, C.A. (2012) Insomnia treatment acceptability and preferences for male Iraq and Afghanistan combat Veterans and their healthcare providers. Journal of Rehabilitation Research and Development, 49, 867-878.
[16] Corrigan, P.W. and Salzer, M.S. (2003) The conflict between random assignment and treatment preference: Implications for internal validity. Evaluation and Program Planning, 26, 109-121.
[17] Sidani, S., Epstein, D. and Miranda, J. (2006) Eliciting patient treatment preferences: A strategy to integrative evidence-based and patient-centered care. Worldviews on Evidence Based Nursing, 3, 116-123.
[18] Swift, J.K., Callahan, J.L. and Vollmer, B.M. (2011) Preferences. Journal of Clinical Psychology, 67, 155-165.
[19] Sidani, S. and Braden, C.J. (2011) Design, evaluation, and translation of nursing interventions. Wiley-Blackwell, Ames, IA.
[20] Lin, P., Campbell, D.G., Chaney, E.F., Liu, C., Heagerty, P., Felker, B.L. and Hedrick, S.C. (2005) The influence of patient preference on depression treatment in primary care. Annals of Behavioral Medicine, 30, 164-173.
[21] Mergl, R., Henkel, V., Allgaier, A.K., Kramer, D., Hautzinger, M., Kohen, R., Coyne, J. and Hegerl, U. (2011) Are treatment preferences relevant in response to serotonergic antidepressants and cognitive-behavioral therapy in depressed primary care patients? Results from a randomized controlled trial including a patients’ choice arm. Psychotherapy and Psychosomatics, 80, 39-47.
[22] Swift, J.K. and Callahan, J.L. (2009) The impact of client treatment preferences on outcome: A meta-analysis. Journal of Clinical Psychology, 65, 368-381.
[23] Miranda, J. (2004) An exploration of participants’ treatment preferences in a partial RCT. Canadian Journal of Nursing Research, 41, 276-290.
[24] Sidani, S., Miranda, J., Epstein, D. and Fox, M. (2009) Influence of treatment preferences on validity: A review. Canadian Journal of Nursing Research, 41, 52-67.
[25] Jansen, S.J.T., Stiggelbout, A.M., Wakker, P.P., Nooij, M.A., Noordijk, E.M. and Kievit, J. (2000) Unstable preferences: A shift in valuation or an effect of the elicitation procedure? Medical Decision Making, 20, 62-71.
[26] Irwin, M.R., Cole, J. and Nicassio, P.M. (2006) Comparative analysis of behavioral interventions for insomnia and their efficacy in middle-aged adults and older adults 55 + years of age. Health Psychology, 25, 3-14.
[27] Morin, C.M., Bootain, R.R., Buysse, D.J., Edinger, J.D., Espie, C.A. and Lichstein, K.L. (2006) Psychological and behavioral treatment of insomnia: Update of the recent evidence (1998-2004). Sleep, 29, 1398-1414.
[28] Bastien, C.H., Vallieres, A. and Morin, C.M. (2001) Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Medicine, 2, 297-307.
[29] Sidani, S., Epstein, D.R., Bootzin, R.R., Moritz, P. and Miranda, J. (2009) Assessment of preferences for treatment: Validation of a measure. Research in Nursing and Health, 32, 419-431.
[30] Sidani, S., Miranda, J, Epstein, D.R., Bootzin, R.R., Cousins, J. and Moritz, P. (2009) Relationships between personal beliefs and treatment acceptability, and preferences for behavioral treatments. Behavior Research and Therapy, 47, 823-829.
[31] Zoeller, L.A., Feeny, N.C., Cochran, B. and Pruitt, L. (2003) Treatment choice for PTSD. Behaviour Research and Therapy, 41, 879-886.
[32] Lambert, N., Rowe, G., Bowling, A., Ebrahim, S., Laurence, M., Dalrymple, J. and Thomson, R. (2004) Reasons underpinning patients’ preferences for various angina treatments. Health Expectations, 6, 246-256.
[33] Awad, M.A., Shapiro, S.H., Lund, J.P. and Feine, J.S. (2000) Determinants of patients’ treatment preferences in a clinical trial. Community Dentistry and Oral Epidemiology, 28, 119-125.

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