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Insomnia therapy: What works, what doesn’t?

Rating

3 Star

Insomnia therapy: What works, what doesn’t?

Our Review Summary

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.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

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.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

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.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

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. 

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

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. 

Does the story commit disease-mongering?

Satisfactory

This story did not exaggerate the prevalence or seriousness of insomnia. 

Does the story use independent sources and identify conflicts of interest?

Satisfactory

Independent experts were interviewed for this story.  In addition, the writer pointed out that the study was funded by the NIH.   

Does the story compare the new approach with existing alternatives?

Satisfactory

The story discusses over-the-counter and prescription sleep aids, as well as good sleep habits.  

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

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.

Does the story establish the true novelty of the approach?

Satisfactory

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.   

Does the story appear to rely solely or largely on a news release?

Satisfactory

This story did not appear to rely on the news release.  

Total Score: 5 of 10 Satisfactory

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