Active and placebo effects in treatment of moderate and severe insomnia

Examined the efficacy of relaxation training and a highly credible placebo in the treatment of both severe and moderate sleep onset insomnia. The placebo treatment was designed to elicit an expectation for improvement comparable with that of relaxation training. Expectancy of improvement was further controlled by informing Ss to expect improvement only after the 3rd wk of therapy, thus allowing comparisons of the treatments to be made during the counterdemand period (1st 3 wks) and the positive demand period (4th wk and beyond). Responses of 30 18-76 yr old severe and moderate insomniacs were similar across treatment conditions, over weeks, and in response to the counterdemand/positive demand manipulation. Only Ss trained in relaxation techniques improved significantly during the counterdemand period. The active treatment was significantly more effective than the placebo in reducing sleep onset latency during the counterdemand period. After the introduction of positive expectancy of therapy outcome, relaxation was no longer superior to placebo. Findings are discussed in terms of the methodological difficulties inherent in controlling for S expectancy of therapeutic effects in treatment studies of insomnia. (15 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved).