Pregnant Patients Show Preference For Certain Insomnia Interventions More Than Others
SEATTLE, WA—Pregnant women are likely to choose psychotherapy or acupuncture rather than pharmacotherapy for treatment of insomnia, according to data presented at SLEEP 2015. Ivan Sedov, BA, of the University of Calgary, Calgary, Alberta, Canada, said that women have more favorable perceptions of these interventions.
His group undertook an investigation of preferred approaches to insomnia in pregnant women because sleep tends to worsen as pregnancy suggests, with 20–30% of pregnant women experiencing clinically significant insomnia during their third trimester. Several treatments are available for insomnia during pregnancy, but little is known about how these interventions are perceived by pregnant women. The investigation examined perceptions of three insomnia treatments among pregnant women: pharmacotherapy, cognitive behavioral therapy for insomnia (CBT-I), and acupuncture in 54 pregnant women.
As measured by the Insomnia Severity Index (ISI), 40.7% of the women had significant complaints of insomnia. Participants were asked to read treatment descriptions of each intervention and to complete questionnaires assessing their perceptions of the treatment. The questionnaires included the Credibility Scale (CS), to assess how credible the participants perceived each treatment to be, and Personal Reactions to the Rationale Scale (PRR), to assess the perceived usefulness of the treatment to the participant.
Ratings of treatment credibility differenced significantly between all interventions (P<0.001), with CBT-I rated as more credible than acupuncture (d=0.87; P=0.01) and pharmacotherapy (d=1.56; P<0.001). Participants' personal reactions also differed, with CBT-I rated more favorably than acupuncture (d=1.19, P<0.001) and pharmacotherapy (d=2.18; P<0.001).
When participants were forced to choose a treatment, acupuncture was selected most frequently (52%), followed by CBT-I (38%). Only 10% of women said they would choose pharmacotherapy.
“Patient preferences are increasingly being recognized as an important factor in the delivery of evidence-based interventions,” Sedov observed. Results of this study points to the preferences of pregnant women for the nonpharmacologic interventions for insomnia, and emphasize the need to test and improve these methods.