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Updated: Feb 22, 2026

Multi-Modal Home Sleep Monitoring in Older Adults
Published on: January 26, 2019
Cognitive Expectancies for Hypnotic Use among Older Adult Veterans with Chronic Insomnia
Constance H Fung1,2, Jennifer L Martin1,2, Karen Josephson1
1a Geriatric Research, Education and Clinical Center , VA Greater Los Angeles Healthcare System , Los Angeles , California , USA.
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.
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