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About 5 Percent of Adults with Insomnia Use Alternative Therapies

CHICAGO - More than 1.6 million U.S. adults are estimated to use complementary and alternative therapies to treat insomnia or trouble sleeping, according to the results of a// national survey published in the September 18 issue of Archives of Internal Medicine, a theme issue on sleep.

Approximately 10 to 34 percent of Americans regularly experience difficulty sleeping, also known as insomnia, according to background information in the article. Treatment options include prescription and non-prescription medications, antidepressants and cognitive behavioral therapy. Complementary and alternative medicine (CAM) therapies, defined as those practices that are not scientifically proven and are not currently considered part of conventional medicine, also are used to treat insomnia. Such therapies include herbal medicines and relaxation techniques.

Nancy J. Pearson, Ph.D., and colleagues at the National Center for Complementary and Alternative Medicine, National Institutes of Health, Bethesda, Md., analyzed data from a national survey of 31,044 adults conducted in 2002. Respondents answered one question about whether they had difficulty sleeping in the past 12 months and completed a 10-minute supplemental survey on the use of 27 types of CAM therapies. The interview also included questions about five other health conditions: depression and anxiety, congestive heart failure, diabetes, hypertension (high blood pressure) and obesity. Four items assessed behavior and motivation for using CAM therapies.

Of the adults interviewed, 17.4 percent reported that they had insomnia or trouble sleeping in the past year. Difficulty sleeping was more common in women than men, most prevalent between ages 45 and 64, and was associated with obesity, hypertension, congestive heart failure and anxiety or depression, but not diabetes. Of those with insomnia or trouble sleeping, 4.5 percent reported that they had used CAM to treat the condition, which is equal to about 1.62 million adults in the general population. Survey respondents who were younger and who had a higher level of education were more likely to use CAM to help them sleep; use of CAM was not related to having any of the five medical conditions studied.

Among those who use CAM therapies, 60.7 percent told their conventional physician. Sixty-five percent used biological methods, which include herbal medicines, diet interventions and vitamin therapy, and mind-body therapies such as meditation were used by 39 percent. Fifty-six percent reported that the therapy was very important to their health and well-being.

Forty-nine percent of those who used herbal medicine and 48 percent of those who used relaxation therapy reported that CAM helped alleviate their condition. "Although the question asking whether the CAM therapy helped provides useful information on the public's perception of effectiveness of CAM therapies for insomnia or trouble sleeping, it does not directly address the efficacy of the CAM therapy," the authors write. "A positive answer to this question could be due to a placebo effect, the natural history of the condition or other unidentified influences rather than efficacy of the CAM treatment." The survey results provide valuable information about the use of CAM that can guide future studies of whether these therapies are effective, they conclude.

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