Treatment of Chronic Insomnia With Cognitive Behavioral Therapy vs Zopiclone—Reply

KEYWORDS:
• COGNITIVE THERAPY
• NEUROPSYCHOLOGICAL TESTS
• POLYSOMNOGRAPHY
• SLEEP INITIATION AND MAINTENANCE DISORDERS
• ZOPICLONE

In Reply: I agree with Dr Persaud in his comment that future insomnia research should also include secondary outcome measures related to daytime functioning and sleepiness. The state of hyperarousals often seen in individuals with chronic insomnia warrants such measures. In our study, we administered neuropsychological tests measuring both attention and concentration. Due to only minor baseline deficits in our sample, however, the measurement of improvements had low clinical significance. Our research team is currently examining the treatment effects of CBT and zopiclone on various psychosocial outcomes, such as anxiety, depression, and worry.

In response to Dr Lesser, I agree that it would be valuable to include individuals with insomnia who had never previously received treatment, and thus test for possible selection biases. Regarding the selection bias that he suggests may be have been present, adjusting for previous treatment of insomnia in the statistical analyses did not result in any …