A new international study led by Dalhousie University in collaboration with Monash University has demonstrated that self-guided interventions can significantly reduce long-term use of sleeping pills among older adults with insomnia. This groundbreaking research, published in JAMA Psychiatry, offers a simple and scalable solution to a persistent public health issue.
Sleeping pills, particularly benzodiazepines, are commonly prescribed for insomnia, but their long-term use is fraught with risks such as cognitive impairment, falls, and other serious health issues. In Australia alone, approximately 7 million benzodiazepine prescriptions are recorded annually, with elderly patients being particularly vulnerable.
The study, which included 1,295 participants, compared two intervention groups—Sleepwell and EMPOWER—with a control group that received no intervention. At the six-month mark, the Sleepwell group had the highest rate of sleeping pill discontinuation and dose reduction (46.6%), while the EMPOWER group achieved a 34.8% reduction.
Dr Justin Turner from the Centre for Medicine Use and Safety at Monash University attributed the success of Sleepwell to its emphasis on cognitive behavioural therapy for insomnia (CBTI). “With Sleepwell, individuals were given two booklets—‘How to Stop Sleeping Pills’ and ‘How to Get Your Sleep Back’—along with access to a website designed to integrate behaviour change techniques,” Dr Turner explained.
Professor David Gardner from Dalhousie University, the lead author of the study, noted that previous efforts to reduce sleeping pill use focused on educating healthcare professionals. “For this study, we went straight to the people taking the sleeping pills,” Gardner said. “Encouragingly, in addition to reducing their use of sleeping pills, people in the Sleepwell group had better sleep and less daytime sleepiness compared to the other groups.”
Cognitive behavioural therapy for insomnia is considered the first-line treatment for insomnia and has been shown to provide long-lasting benefits without the risks associated with sleeping pills.
The study underscores the need for evidence-based interventions to address the widespread use of sleeping pills among older adults. Dr Turner highlighted the relevance of these findings for Australia, given its similar demographic profile and healthcare system to Canada. “We encourage the Australian government to consider implementing and evaluating this direct-to-patient educational approach,” Turner said.
The full research team included experts from Dalhousie University, the University of New Brunswick, and Monash University.
Ritchelle is a Content Producer for Healthcare Channel, Australia’s premier resource of information for healthcare.
