Hullar Julien, Vespignani Hervé, Fay Renaud, Boivin Jean-Marc
Faculté de médecine de Nancy, université Henri-Poincaré, CIC, Inserm CIC9501.
Rev Prat. 2010 Jun 20;60(6 Suppl):21-6.
The prescription of hypnotic drugs in the management of adult insomnia is a public health issue. The implementation of a non-pharmacological, therapeutic approach is a daily problem for primary physicians.
This study aimed at assessing the impact of a group therapeutic education approach in the non-medical management of adult insomnia by general practitioners.
Prospective study conducted from September 2007 to March 2008. Two conferences were held in a two-month period by 5 general practitioners from Laxou, Meurthe-et-Moselle (France). Volunteers were recruited by general practitioners, through local press, posters displayed in pharmacies, leaflet distribution and local radio announcements. A questionnaire was provided at the beginning and the end of the conferences. A phone interview was conducted 1 month and 3 months after the conferences were held, to assess their impact.
Seventy-six participants completed the questionnaire during both conferences, and 55 adults were followed-up at 1 and 3 months; 58% (n = 43) were aged over 60, and women represented 65% (n = 48) of the participants; 63% (n = 46) reported insomnia, out of which 89% complained of chronic insomnia (26%, 40% and 34% reported mild insomnia, moderate insomnia and severe insomnia, respectively). At 3 months, 20% of the participants had completed the sleep diary and specifically seen their general practitioner; 56% of the participants taking hypnotic drugs had initiated a dose reduction or a discontinuation of their treatment; 84% of the participants who followed recommendations and initiated cognitive behavioral therapies noted a partial or complete improvement in their sleep disorder.
Group therapeutic education in the form of cognitive behavioral therapy performed during a conference results in a change in behaviors and a mid-term improvement in sleep quality in participants.