This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related letters  • Similar articles in JAMA  Topic Collections  • Psychiatry  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: In the study of CBT vs zopiclone for treatment of chronic primary insomnia by Dr Sivertsen and colleagues,¹ I believe that there are problems relating to methodology and interpretation that limit the usefulness of their results for the medical practitioner.

The authors do not discuss a serious intrinsic bias in selecting community volunteers. Persons with insomnia may be initially seen by a physician and prescribed a hypnotic medication. For many the hypnotic may be reasonably successful and therefore continued in controlled doses regularly or episodically for years to decades. Members of this "therapeutically successful" cohort would be unlikely to volunteer for an insomnia study.

It seems unlikely that in the United States (and presumably in Norway) very many individuals with insomnia are initially referred for the more complex and costly CBT. Thus, the method of subject selection in Sivertsen et al¹ likely excluded persons for whom a . . . [Full Text of this Article]

Gerson T. Lesser, MD
glesser@jhha.org
Department of Geriatrics and Adult Development
Mount Sinai School of Medicine
New York, NY

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTERS

Treatment of Chronic Insomnia With Cognitive Behavioral Therapy vs Zopiclone
Raj Persaud
JAMA. 2006;296(20):2435.
EXTRACT | FULL TEXT  

Treatment of Chronic Insomnia With Cognitive Behavioral Therapy vs Zopiclone—Reply
Børge Sivertsen
JAMA. 2006;296(20):2436.
EXTRACT | FULL TEXT