In Reply: I agree with Dr Persaud in his comment that future insomnia research should also include secondary outcome measures related to daytime functioning and sleepiness. The state of hyperarousals often seen in individuals with chronic insomnia warrants such measures. In our study, we administered neuropsychological tests measuring both attention and concentration. Due to only minor baseline deficits in our sample, however, the measurement of improvements had low clinical significance. Our research team is currently examining the treatment effects of CBT and zopiclone on various psychosocial outcomes, such as anxiety, depression, and worry.
Sivertsen B. Treatment of Chronic Insomnia With Cognitive Behavioral Therapy vs Zopiclone—Reply. JAMA. 2006;296(20):2435–2436. doi:10.1001/jama.296.20.2436-a
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