Abstract
The importance of differences in pre-sleep cognitive intrusions in the treatment of sleep-onset insomnia were investigated. Twenty-four patients suffering from persistent psychophysiological insomnia were assessed on a pre-sleep cognitive intrusion inventory and divided into high and low scorers. Within these groups Ss were randomly assigned to either a cognitively focused program (cognitive restructuring. paradoxical instructions and thought stopping) or a psychophysiologically focused method, EMG-biofeedback training. Patients were treated individually for 6 sessions. Within-group comparisons showed that both treatments yielded significant improvement in latency to falling asleep, pre-sleep tension, hours of sleep and sleep quality. Between-group comparisons showed a greater reduction of pre-sleep intrusions in patients treated by the cognitive method and of pre-sleep tension in patients trained in biofeedback, but no differential results were found in outcome variables either after treatments or at 3- and 12-month follow-ups. The results indicate that the use of differential treatments added little to the outcome of therapy, and do not support the hypothesis that greater benefits are gained when the treatment matches the patient's claims of cognitive hyperarousal.
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