Cognitive behavioral therapy vs. Imovane for insomnia

About 5% to 20% of adults suffer from insomnia. Nearly half report at least occasional sleeping problems.

Now, the results of a clinical trial published in The Journal of the American Medical Association suggest that interventions based on cognitive behavioral therapy (CBT) are superior to Imovane in short- and long-term management of insomnia in older adults (average age: 61 years).”

Imovane (zopiclone) is approved by the U.S. Food and Drug Administration for short-term management of insomnia characterized by difficulty in falling asleep, frequent awakenings at night, and/or early morning awakening.

In clinical trials, Imovane (which is not classified as a benzodiazepine) has been at least as effective as the benzodiazepines in the treatment of insomnia, although comparisons between Imovane and the benzodiazepine (Dalmane) flurazepam have produced inconsistent results.

For most outcomes, Imovane did not differ from placebo. Participants receiving CBT improved their sleep efficiency at the 6-month follow-up compared to a decrease in the Imovane group. Participants in the CBT group spent more time in slow-wave sleep (stages 3 and 4) compared to those in other groups, and less time awake during the night.

The researchers concluded that the findings have “important implications for the clinical management of chronic insomnia in older adults.” “Given the increasing amount of evidence of the lasting clinical effects of CBT and lack of evidence of long-term efficacy of hypnotics, clinicians should consider prescribing hypnotics only for acute insomnia.”

The challenge is that qualified practitioners to provide CBT-based interventions for insomnia are not widely available.

7/7/06 22:23 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.