Behavioural, medication strategies preferred for insomnia treatment

Primary care patients favour behavioural and medication treatment for their insomnia, a study reports. However, they are more likely to choose behavioural treatment with worsening mental health and sleep.

The study included 200 patients (mean age 54.92 years) who attended a university medical centre and community health clinic. They underwent brief screenings for insomnia, depression, anxiety, and insomnia treatment preference.

Researchers evaluated insomnia symptoms using the Insomnia Severity Index, whereas depressive and anxiety symptoms were assessed using the Patient Health Questionnaire 2 and Generalized Anxiety Disorder 2.

Of the patients, 46.5 percent expressed preference for medication while 56.0 percent conveyed preference for behavioural treatment (ratings not exclusionary). Patients with severe insomnia presentations mostly favoured behavioural (15.2 percent preferred vs 4.5 percent disliked; p=0.002). Meanwhile, those with elevated anxiety were more likely to prefer medication (57.3 percent preferred vs 42.7 percent disliked; p=0.017).

Finally, patients with elevated depression highly preferred behavioural treatment (66.7 percent preferred to 33.3 percent disliked; p=0.012) and medication (56.8 percent preferred vs 43.2 percent disliked; p=0.016).

Treatment preference only differed by age for behavioural treatment (p=0.008), with preference being the highest among patients aged ≤51 years (67.2 percent preferred vs 32.8 percent disliked).

The findings have important implications, as knowledge of patient treatment preference may facilitate shared decision making, which increases patient satisfaction with care and engagement with treatment.