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Short-term pill-free therapy may help insomniacs

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4 Star

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Short-term pill-free therapy may help insomniacs

Our Review Summary

There is a lot to like about the possibility of a treatment for insomnia that doesn’t rely on sleeping pills or intense and expensive counseling by specialists. While this story paints a reasonably fair picture of a small test of a brief behavioral therapy for insomnia, the overall impression given to readers may have shaded toward emphasizing the positive while skipping over uncertainties, future research challenges and possible alternative approaches.

 

Why This Matters

Insomnia affects many people. And we are all subjected to a relentless flood of ads for sleeping pills. News of research into relatively simple approaches that don’t rely on drugs is understandably welcome, but stories about small, preliminary trials need to be frank about the limitations.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

Although this trial was a preliminary experiment, the proposed intervention is clearly defined as two office visits and two telephone calls with a nurse, so it should have been possible to estimate the cost. Since one purpose of testing this sort of brief intervention is to offer lower-cost alternatives to established behavioral treatment for insomnia, readers should have been given some estimate of the relative costs of the interventions.

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

Not Satisfactory

The story tells readers that 55 percent of people in the active intervention group no longer met the criteria for insomnia after four weeks. However, readers are not told how the researchers defined insomnia. Was it a complete inability to sleep? How frequently did the participants have trouble sleeping? How much more did they sleep after treatment? Without these and other details, it is difficult to get a feel for what effect the treatment had.

While this story reported how many people needed to be treated in order to make a difference for at least one… a statistic we encourage journalists to use more… the story reported twice as many people benefited as the researchers actually said they saw. The researchers wrote that one person either had remission (no more insomnia) or response (significantly less insomnia) for every 2.4 people treated. But the story says that for every 2.4 participants treated one responded and one overcame insomnia.

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

Not Applicable

We won’t hold this story to this criterion because neither the journal article on the test nor an accompanying commentary noted any adverse events. However, the story could have pointed out that a trial this small generally would miss all but the most common problems. Also, the story could have pointed out that until further evidence is developed, it is not know for certain how this type of intervention compares with alternatives. If it turns out that for some people this treatment is less effective than alternatives, then prescribing it would mean leaving them at greater risk of being harmed by insomnia.

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

Satisfactory

The story gives a brief description of the experiment and some of the main outcomes that the researchers measured. The story would have been better if it told readers more about the limitations of this small trial, including what sort of further testing would be needed to determine if the intervention would work for people in the general population, rather than just those who match the profiles of the individuals who volunteered to participate in this test. The story compared this brief intervention to more established behavioral therapy, without noting the pitfalls of trying to compare results from different trials. The story did not tell readers that there is ongoing debate about the best way to measure the results of insomnia studies.

Does the story commit disease-mongering?

Satisfactory

The story provides estimates of how many people complain of insomnia. It also portrays this intervention as an alternative to existing treatments, rather than an effort to expand treatment to more people.

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

Satisfactory

The story includes comments from the author of a commentary article that appeared in the Archives of Internal Medicine along with the research article. In the disclosure section of their article, some of the researchers reported ties to pharmaceutical companies, but since this trial tested a non-drug approach and was funded by public agency and academic grants, it seems reasonable to consider the industry links as not being relevant to this study.

Does the story compare the new approach with existing alternatives?

Satisfactory

We will credit this story for discussing the alternatives of sleeping pills and cognitive behavioral therapy. Although there was no reference to other less-intense non-drug approaches that clinicians may recommend for dealing with insomnia, there was a comment at the end of the story that offered some basic advice that readers could use on their own.

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

Satisfactory

The story says this form of “brief behavioral treatment for insomnia is not yet generally available”. It also described this study as being a first step in the process of making such an intervention available without making predictions about a timetable.

Does the story establish the true novelty of the approach?

Not Satisfactory

This story suggests that there are no brief behavioral interventions available to people with insomnia. They story should not have suggested that the only alternative treatments are drugs and expensive cognitive behavioral therapy.

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

Satisfactory

The story does not appear to rely on a news release.

Total Score: 6 of 9 Satisfactory

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