This story appears to be a general piece on treating insomnia; however, it briefly mentions a recent trial published in JAMA, which found that discontinuing sleep medications after six weeks and continuing with cognitive behavioral therapy was effective in treating sleep problems. Unfortunately, little space is devoted to discussing the methodology and quantitative results of the trial and the reader is left to wonder what drug was used in the study, how long were the participants treated, and whether the results are clinically significant. If the writer had explored the JAMA study more, the lay public may have been more aware of the benefits of this treatment strategy. This would help lay the groundwork for more informed conversations between patients and doctors about prescription sleep medications, with their modest value and many problems.
There was no discussion of the costs associated with cognitive behavioral therapy or prescription sleep medications. It would have been important to note that many patients choose medications because they are relatively inexpensive compared to cognitive behavioral therapy, which is not always covered by insurance and requires time away from work to complete.
No data from the trial were provided to help the reader decide if the strategy of stopping medications and continuing with cognitive behavioral therapy is superior. It should have been noted that while the results were statistically significant, their clinical significance is less clear.
While the story mentioned that sleep aid medications can have side effects, no data were provided. Serious side effects are associated with Ambien, the study drug, including amnesia. It also failed to mention whether or not there are any harms associated with cognitive behavioral therapy.
The story only devoted one sentence to describing the methodology and results of the JAMA trial and in doing so failed to provide any qualitative data or information regarding the study medication, including its name, dosage, and duration of use. The reader is also not given any information on what comprised the cognitive behavioral therapy used in this study and how long patients received the therapy. It would also be important to note that all of the study participants were white, which may suggest that the results are not applicable to the general population.
This story did not exaggerate the prevalence or seriousness of insomnia.
Independent experts were interviewed for this story. In addition, the writer pointed out that the study was funded by the NIH.
The story discusses over-the-counter and prescription sleep aids, as well as good sleep habits.
Sleep medication is widely available; however the story should have clarified that not all geographic areas have access to cognitive behavioral therapy, particularly for treating sleep problems.
Treating insomnia with a combination of pharmacotherapy and behavioral therapy is not novel; however, the notion of discontinuing drug treatment after the initial 6 weeks and continuing with therapy appears to be a new strategy.
This story did not appear to rely on the news release.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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