Insomnia's cure proves elusive for researchers

A panel of sleep experts pointed to cognitive behavioral therapy and medications approved for sleep disorders as good but little-used treatments.

By Susan J. Landers, AMNews staff. July 11, 2005.

Washington -- Helping patients attain a good night's rest is a goal for many physicians, but what to recommend is not always clear.

Adequate sleep seems to be regularly out of reach for an estimated 40 million to 70 million Americans and effective treatments are elusive, said a panel of sleep experts convened by the National Institutes of Health on June 13-15.

Insomnia is the most commonly reported sleep problem in the industrialized world, and many with the problem often turn to unproven medications to gain some rest, testified Manisha Witmans, MD, who is a sleep medicine specialist and assistant professor at the University of Alberta in Canada.

A sleep problem can be a disorder on its own or it can be a symptom of something else, most commonly depression. Lack of sleep is associated with mood disturbances, difficulties with concentration and memory, and some cardiovascular, pulmonary and gastrointestinal disorders. It has even been implicated in the rising levels of obesity.

"We know that patients can struggle for years with insomnia, and we know that they use a variety of over-the-counter and prescription drugs to deal with it," said Alan Leshner, PhD, chief executive officer of the American Assn. for the Advancement of Science, and the chair of the panel. "Unfortunately, we found insufficient evidence to recommend most of these treatments for long-term use."

Vaughn McCall, MD, professor and chair of the Psychiatry Dept. at Wake Forest University Baptist Medical Center in Winston-Salem, N.C., told the panel he could find no evidence that randomized controlled clinical trials had ever been conducted for five of the 10 pharmaceuticals prescribed most often for chronic insomnia.