Long-term follow-up of chronic insomnia

In order to assess the long-term outcome of sleep disturbance, 28 well-characterized patients with psychophysiological insomnia or sleep state misperception were given structured interviews 40 months and 64 months after initial assessment. Most patients still reported sleep disturbance, albeit with some improvement. The number of nights per week of disturbed sleep decreased, subjective total sleep time increased, daytime sleepiness declined, there was an increase in feeling refreshed in the morning and there was a trend toward decreased global complaints of poor sleep. Subjective sleep latency was unchanged, and the only parameter that worsened was difficulty falling asleep. Only a minority of the patients (18%) were taking prescription hypnotics at follow-up, but these patients believed that they were of benefit. There was a significant rate of increase in the use of over-the-counter hypnotics at the time of the second follow-up, although there was a low rate of satisfaction associated with them.