Rogev Eldor, Pillar Giora
Sleep Laboratory, Rambam Health Care Campus, Haifa, Israel.
Isr Med Assoc J. 2013 Aug;15(8):434-8.
Insomnia is the most common sleep disorder. Treatment options are improved sleep hygiene, relaxation, cognitive behavioral therapy, and medications. Studies examining the effect of hypnotics on insomnia reported that placebo had a substantial beneficial effect.
To evaluate whether placebo is an effective treatment for insomnia.
We assessed 25 patients with insomnia who were enrolled in a hypnotic study but prior to the study were asked to undergo two full nights in laboratory polysomnography studies: with and without a placebo. Although they were not explicitly told that they were receiving a placebo, the participants knew that the results of these studies would determine whether they met the criteria to participate in the pharmaceutical study.
Although the participants acknowledged that they were given a placebo, almost all measures of their sleep improved. With placebo, sleep latency was shortened from 55.8 +/- 43.5 to 39.8 +/- 58.5 minutes (P < 0.05); total sleep time was extended from 283 +/- 72.5 to 362.9 +/- 56.3 minutes, and sleep efficiency improved from 59.57 +/- 14.78 to 75.5 +/- 11.70% (P < 0.05). Interestingly, placebo had no effect on the relative sleep stage distribution (percentage of total sleep time), except for a trend toward increased percentage of REM sleep.
Our findings show a clear and significant beneficial effect of placebo on insomnia, despite participants' understanding that they were receiving placebo. These results emphasize the importance of the patients' perception and belief in insomnia treatment, and suggest that in some cases placebo may serve as a treatment.
失眠是最常见的睡眠障碍。治疗方法包括改善睡眠卫生、放松、认知行为疗法和药物治疗。研究催眠药物对失眠影响的报告指出，安慰剂具有显著的有益效果。
评估安慰剂是否是治疗失眠的有效方法。
我们评估了25名失眠患者，他们参与了一项催眠药物研究，但在研究前被要求在实验室进行两晚的多导睡眠图研究：一晚使用安慰剂，另一晚不使用。尽管未明确告知他们使用的是安慰剂，但参与者知道这些研究结果将决定他们是否符合参与药物研究的标准。
尽管参与者承认他们使用了安慰剂，但几乎所有睡眠指标都有所改善。使用安慰剂时，睡眠潜伏期从55.8±43.5分钟缩短至39.8±58.5分钟（P<0.05）；总睡眠时间从283±72.5分钟延长至362.9±56.3分钟，睡眠效率从59.57±14.78%提高至75.5±11.70%（P<0.05）。有趣的是，安慰剂对相对睡眠阶段分布（总睡眠时间的百分比）没有影响，除了快速眼动睡眠百分比有增加的趋势。
我们的研究结果表明，尽管参与者知道自己使用的是安慰剂，但安慰剂对失眠仍有明显且显著的有益效果。这些结果强调了患者对失眠治疗的认知和信念的重要性，并表明在某些情况下安慰剂可能可作为一种治疗方法。
