Video: Sleepless in America: Therapy vs. pills

By Robert Bazell Chief science and health correspondent
NBC News
updated 6/27/2006 7:26:31 PM ET 2006-06-27T23:26:31

A good night's sleep is a struggle for one in 10 American adults like Drora Arnon.

"There were nights that I thought I would be losing my mind if this continues," he says.

To cope, many take sleeping pills — doctors wrote 42 million prescriptions last year, up 60 percent since 2001 — making sleeping pills a $2 billion industry.

Dr. Charles Cantor of the University of Pennsylvania worries no one understands the long term effects on chronic sleeping pill users.

"The theoretical problem is they may become tolerant to the medication and may require increasing doses," he says, "and then, if they stop, they may have incredible difficulty getting off the medication."

There is a simple alternative called cognitive behavioral therapy, and a study out Tuesday, published in the Journal of the American Medical Association, shows it works better than pills. The treatment entails several days or weeks of talk therapy. A doctor or other professional records a person's sleep habits then re-educates them on how to relax, put the day's worries out of their mind and learn to put themselves to sleep.

The key to the therapy is an individualized sleep routine. Often that means avoiding caffeine after noon and exercise late in the day. And before getting into bed, turn off that TV.

Patients treated with therapy spent more time in the deepest stages of sleep and less time awake at night compared to patients on the sleeping pill zopiclone. In fact, the sleeping pill did no better than the placebo in many ways.

"I think a behavioral approach is a great way to start for most people," says Dr. Grace Pien of the University of Pennsylvania.

Hundreds of clinics offer behavioral sleep therapy. But often they are booked for months, and many people just can't find the time for the treatment in their busy, sleepless lives.

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