IX. Study of AudioMagic Sleep Programs on Insomnia Patients

Studied: AudioMagic™ Natural Sleep programs                                                                
Conducted by
: Dr. Bruce Rybarczyk, Virginia Commonwealth University

Funded by
: National Institute of Health

In this study, two different forms of home-based, self-help therapy for insomnia were compared in a group of older adults with different comorbidities, arthritis and coronary artery disease.

  • a purely text-based (book) home version of Mimeault and Morin's Cognitive Behavioral Therapy for the treatment of Insomnia (CBT-I)
  • and a multimedia approach that included a guidebook with traditional CBT-I instructions, weekly videos of classroom instruction, and audio (in the form of a progressive series of 3D Living Sound AudioMagic™ Natural Sleep programs)

This followed from a review of research in multiple domains of self-help behavioral interventions which indicated that multimedia strategies are more effective than reading materials alone (Mains & Scogin, 2003) by demonstrating that using multi-modal instructional methods increases the likelihood that the material will be thoroughly reviewed and facilitates learning and subsequent enactment of behavioral changes.

Morin (2003) has argued that since insomnia has been associated with significant morbidity and quality of life effects, effective treatments should not only produce changes in sleep parameters but also other measures of daytime functioning. As such, this study measured not only a variety of sleep factors but an array of daytime mood and general health measures as well. That way, this study could also test the hypothesis that CBT-I would lead to benefits in daytime functioning as a consequence of improved sleep. 

In an intention-to-treat analysis that included all participants, the 3D Living Sound approach demonstrated statistically significant superiority in 3 global sleep measures – Pittsburgh Sleep Quality Index, Sleep Impairment Index, Dysfunctional Beliefs and Attitudes about Sleep immediately after the intervention training was completed.

In contrast, there were no significant differences between the two treatment groups or the primary and comorbid insomnia groups on any baseline sleep measure, however there were notable differences in the clinical significance outcomes at post-treatment

The book group had:

  • 14 clinically significant improvements
  • 10 moderately clinically significant improvements
  • 2 substantial improvements
  • 32 no improvements
The multimedia group had:
  • 16 clinically significant improvements
  • 13 moderately clinically significant improvements
  • 19 no improvements

When combining the 3 clinical improvement categories together, the multimedia group had an overall rate of 60.4% clinically significant change compared to 44.8% for book group. 

The findings from the present study indicate that home treatment CBT-I is an effective treatment for both primary insomnia and comorbid insomnia in older adults, with the combined rate of clinically significant change at 52%. This suggests only a moderate decrease in treatment response compared to in-person classroom treatment, which showed a 78% clinically significant response rate using the same criteria in a comparable study. But even that small difference diminishes when one considers how much more laborious the 6-week in-classroom program was over the at-home program, listening to headphones in bed at night and using the guidebook and video classes.

Furthermore, there were no differences in treatment response between primary and comorbid insomnia groups in the present study, further supporting the recent consensus among researchers that comorbid insomnia is undergirded by the same cognitive and behavioral factors as primary insomnia and therefore equally responsive to treatment. These overall findings add to the recently published studies showing high levels of efficacy for behavioral treatments that target secondary and comorbid insomnias (Currie et al., 2000; Lichstein et al., 2000; Quesnel et al., 2003; Rybarczyk et al., 2002).

What's more, in a one-year follow-up the CBT-I approach augmented with 3D Living Sound sleep programs continued to demonstrate significant superiority on these major sleep measures. In addition, more subjects using the 3D Living Sound approach showed clinical improvement one year post than subjects using Mimeault and Morin's home CBT-I.

These results were presented at the 2009 meeting of the Society of Behavioral Medicine in Montreal.

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