Magazine article Clinical Psychiatry News

Sleep-Deprivation Regimen Brings FAST Results: Insomnia Patients Treated with New Therapy Show Improved Sleep Latency, Efficiency, and Total Sleep Time

Magazine article Clinical Psychiatry News

Sleep-Deprivation Regimen Brings FAST Results: Insomnia Patients Treated with New Therapy Show Improved Sleep Latency, Efficiency, and Total Sleep Time

Article excerpt

DENVER -- A novel behavioral therapy conducted over just 26 hours in a single weekend shows promise for the treatment of chronic primary insomnia, Leon Lack, Ph.D., reported at the annual meeting of the Associated Professional Sleep Societies.

Perhaps the most attractive feature of the new Flinders Accelerated Sleep Therapy (FAST) is that it brings an immediate therapeutic response, he said. After their treatment weekend, patients have improved sleep latency, sleep efficiency, and total sleep time.

In contrast, stimulus-control therapy and other forms of cognitive-behavioral therapy, while shown to be quite effective for insomnia, typically require 2-3 weeks before patients begin to see results. During this lag time, daytime sleepiness worsens, which adversely affects quality of life, noted Dr. Lack of Flinders University in Adelaide, Australia.

Also, cognitive-behavioral therapy for insomnia requires considerable patient effort and commitment to comply with the required homework instructions.

"Even though stimulus-control therapy and other cognitive-behavioral therapies have been shown [to be] very effective in clinical trials, we sometimes wonder whether they're as effective in real-world situations where we give instructions to patients and have them carry them out in the home environment. We don't know much about that. And there could be difficulties with people complying with the instructions. If they do, we think they're very effective, but some of these instructions are rather rigorous," he said.

In contrast, FAST is a modified sleep-deprivation regimen involving constant bed rest during the treatment weekend, the psychologist explained. Patients arrive at the sleep laboratory at about 8 p.m. Saturday and get hooked up to the EEG machine. From then until 11 p.m. Sunday they're encouraged to fall asleep--but every time they do, they are awakened after 4 minutes. This typically happens at least 50 times.

During this period patients get very sleepy. Their sleep latencies start dropping. Starting at 11 p.m. Sunday, patients are permitted to have uninterrupted recovery sleep until Monday morning. Then they go home.

Dr. Lack reported on 17 patients (mean age 39 years) with primary insomnia. Their chief sleep problem involved delayed onset, although some also had sleep maintenance difficulties. …

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