Cognitive Expectancies for Hypnotic Use among Older Adult Veterans with Chronic Insomnia
Constance H Fung, Jennifer L Martin, Karen Josephson, Lavinia Fiorentino, Joseph M Dzierzewski, Stella Jouldjian, Yeonsu Song, Juan Carlos Rodriguez Tapia, Michael N Mitchell, Cathy A Alessi, Constance H Fung, Jennifer L Martin, Karen Josephson, Lavinia Fiorentino, Joseph M Dzierzewski, Stella Jouldjian, Yeonsu Song, Juan Carlos Rodriguez Tapia, Michael N Mitchell, Cathy A Alessi
Abstract
Objectives: To examine relationships between cognitive expectancies about sleep and hypnotics and use of medications commonly used for insomnia (hypnotics).
Methods: We analyzed baseline data from older veterans who met diagnostic criteria for insomnia and were enrolled in a trial comparing CBTI delivered by a supervised, sleep educator to an attention control condition (N = 159; 97% male, mean age 72 years). We classified individuals as hypnotic users (N = 23) vs. non-users (N = 135) based upon medication diaries. Associations between hypnotic status and Dysfunctional Beliefs and Attitudes about Sleep-16 (DBAS) total score (0-10, higher = worse) and two DBAS medication item scores (Item 1: "…better off taking a sleeping pill rather than having a poor night's sleep;" Item 2: "Medication… probably the only solution to sleeplessness"; 0-10, higher = worse) were examined in logistic regression models.
Results: Higher scores on the DBAS medication items (both odds ratios = 1.3; p-values < .001) were significantly associated with hypnotic use. DBAS-16 total score was not associated with hypnotic use.
Conclusion: Cognitive expectancy (dysfunctional beliefs) about hypnotics was associated with hypnotic use in older adults with chronic insomnia disorder.
Clinical implications: Strategies that specifically target dysfunctional beliefs about hypnotics are needed and may impact hypnotic use in older adults.
Keywords: Medications; older adults; sleep.
Source: PubMed