{"id":{"repo_id":"auckland-ms","oai_identifier":"oai:researchspace.auckland.ac.nz:2292/22116"},"canonical_url":"https://search.dev.ndltd.org/etd/auckland-ms/oai:researchspace.auckland.ac.nz:2292/22116","repository":{"repo_id":"auckland-ms","name":"University of Auckland","base_url":"https://researchspace.auckland.ac.nz/server/oai/request"},"display":{"title":"Refresh. Restriction For Reorganising Sleep Habit: A randomised controlled trial of simplified sleep restriction for primary insomnia in the primary care setting","abstract":"Rationale: Insomnia is a common health problem for patients in primary care. A literature review conducted by the author concluded that cognitive behavioural therapy for insomnia (CBT-I) is effective but its use has been limited by the time and expense required for delivery. Sleep restriction, or restricting the time in bed, is one component of CBT-I, which could be delivered as a brief intervention during primary care consultations. A systematic review of sleep restriction as a stand-alone treatment for insomnia showed some benefit, but concluded that more evidence was required. Objective: To assess the effectiveness of simplified sleep restriction to improve sleep in primary insomnia. Design, Setting, and Participants: A randomised controlled trial involving adult patients with persistent primary insomnia recruited from general practice clinics in Auckland, New Zealand between 2009 and 2012. Intervention: Intervention patients received 20 minutes of sleep hygiene advice and “simplified sleep restriction” instructions at an initial visit with a general practitioner and 14 minutes of advice and a “sleep self-adjustment algorithm” at two weeks. Control patients received sleep hygiene advice alone at both visits. Main outcomes: The primary outcomes were change in sleep quality at six months as measured by the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and sleep efficiency. Proportion reaching a pre-defined “treatment response” was calculated using PSQI and sleep efficiency. Secondary outcomes included sleepiness, fatigue, sleep-onset latency, wakefulness after sleep onset, total sleep time, depression and anxiety. Potential adverse events (excessive sleepiness, accidents, hospitalisations, physiological parameters) were monitored. Results: Ninety-seven patients were recruited and 94 (97%) completed the study. Simplified sleep restriction led to significantly improved PSQI scores (6.2 vs 8.4, p < 0.001), ISI scores (8.6 vs 11.1, p = 0.001); sleep efficiency (difference between mean changes 2.2%, p = 0.006) and sleep onset latency (difference between mean changes -6.1 minutes, p = 0.04) as measured by actigraphy; and a reduction in fatigue (difference between mean changes -2.3 units, p = 0.04) compared with control. Simplified sleep restriction also produced higher rates of “treatment response” (67% [28/42] vs 41% [20/49]), with an adjusted odds ratio of 2.7 (95% CI, 1.1 to 6.5; p = 0.03). There were no significant differences in other outcomes or adverse effects. Conclusions and Relevance: Simplified sleep restriction is a practical, effective intervention for chronic insomnia in adults suitable for the primary care setting.","abstract_html":"Rationale: Insomnia is a common health problem for patients in primary care. A literature review conducted by the author concluded that cognitive behavioural therapy for insomnia (CBT-I) is effective but its use has been limited by the time and expense required for delivery. Sleep restriction, or restricting the time in bed, is one component of CBT-I, which could be delivered as a brief intervention during primary care consultations. A systematic review of sleep restriction as a stand-alone treatment for insomnia showed some benefit, but concluded that more evidence was required. Objective: To assess the effectiveness of simplified sleep restriction to improve sleep in primary insomnia. Design, Setting, and Participants: A randomised controlled trial involving adult patients with persistent primary insomnia recruited from general practice clinics in Auckland, New Zealand between 2009 and 2012. Intervention: Intervention patients received 20 minutes of sleep hygiene advice and “simplified sleep restriction” instructions at an initial visit with a general practitioner and 14 minutes of advice and a “sleep self-adjustment algorithm” at two weeks. Control patients received sleep hygiene advice alone at both visits. Main outcomes: The primary outcomes were change in sleep quality at six months as measured by the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and sleep efficiency. Proportion reaching a pre-defined “treatment response” was calculated using PSQI and sleep efficiency. Secondary outcomes included sleepiness, fatigue, sleep-onset latency, wakefulness after sleep onset, total sleep time, depression and anxiety. Potential adverse events (excessive sleepiness, accidents, hospitalisations, physiological parameters) were monitored. Results: Ninety-seven patients were recruited and 94 (97%) completed the study. Simplified sleep restriction led to significantly improved PSQI scores (6.2 vs 8.4, p &lt; 0.001), ISI scores (8.6 vs 11.1, p = 0.001); sleep efficiency (difference between mean changes 2.2%, p = 0.006) and sleep onset latency (difference between mean changes -6.1 minutes, p = 0.04) as measured by actigraphy; and a reduction in fatigue (difference between mean changes -2.3 units, p = 0.04) compared with control. Simplified sleep restriction also produced higher rates of “treatment response” (67% [28/42] vs 41% [20/49]), with an adjusted odds ratio of 2.7 (95% CI, 1.1 to 6.5; p = 0.03). There were no significant differences in other outcomes or adverse effects. Conclusions and Relevance: Simplified sleep restriction is a practical, effective intervention for chronic insomnia in adults suitable for the primary care setting.","abstract_has_math":false,"creators":["Falloon, Karen"],"institution":"ResearchSpace@Auckland","degree_name":"PhD","degree_level":"Doctoral","degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Arroll, B","Elley, C"],"committee_chairs":[],"committee_members":[],"year":2014,"date_issued":"2014","date_published":"2014","updated_at":"2026-07-24T01:07:07Z","subjects":[],"languages":[],"rights":["Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher."],"rights_urls":["https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm"],"identifier_entries":[]},"links":{"outbound_url":"https://hdl.handle.net/2292/22116","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Arroll, B","Elley, C"]},{"key":"dc:creator","label":"Author","values":["Falloon, Karen"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2014-05-18T23:16:45Z"]},{"key":"dc:date.issued","label":"Date","values":["2014"]},{"key":"dc:publisher","label":"Institution","values":["ResearchSpace@Auckland"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Doctoral"]},{"key":"thesis:degree_name","label":"Degree Name","values":["PhD"]},{"key":"thesis:institution_name","label":"Thesis Institution Name","values":["The University of Auckland"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:rights","label":"Dc Rights","values":["Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. 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A systematic review of sleep restriction as a stand-alone treatment for insomnia showed some benefit, but concluded that more evidence was required. Objective: To assess the effectiveness of simplified sleep restriction to improve sleep in primary insomnia. Design, Setting, and Participants: A randomised controlled trial involving adult patients with persistent primary insomnia recruited from general practice clinics in Auckland, New Zealand between 2009 and 2012. Intervention: Intervention patients received 20 minutes of sleep hygiene advice and “simplified sleep restriction” instructions at an initial visit with a general practitioner and 14 minutes of advice and a “sleep self-adjustment algorithm” at two weeks. Control patients received sleep hygiene advice alone at both visits. Main outcomes: The primary outcomes were change in sleep quality at six months as measured by the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and sleep efficiency. Proportion reaching a pre-defined “treatment response” was calculated using PSQI and sleep efficiency. Secondary outcomes included sleepiness, fatigue, sleep-onset latency, wakefulness after sleep onset, total sleep time, depression and anxiety. Potential adverse events (excessive sleepiness, accidents, hospitalisations, physiological parameters) were monitored. Results: Ninety-seven patients were recruited and 94 (97%) completed the study. Simplified sleep restriction led to significantly improved PSQI scores (6.2 vs 8.4, p < 0.001), ISI scores (8.6 vs 11.1, p = 0.001); sleep efficiency (difference between mean changes 2.2%, p = 0.006) and sleep onset latency (difference between mean changes -6.1 minutes, p = 0.04) as measured by actigraphy; and a reduction in fatigue (difference between mean changes -2.3 units, p = 0.04) compared with control. Simplified sleep restriction also produced higher rates of “treatment response” (67% [28/42] vs 41% [20/49]), with an adjusted odds ratio of 2.7 (95% CI, 1.1 to 6.5; p = 0.03). There were no significant differences in other outcomes or adverse effects. Conclusions and Relevance: Simplified sleep restriction is a practical, effective intervention for chronic insomnia in adults suitable for the primary care setting."]},{"key":"dc:title","label":"Title","values":["Refresh. Restriction For Reorganising Sleep Habit: A randomised controlled trial of simplified sleep restriction for primary insomnia in the primary care setting"]}]}],"canonical_facts":{"dc:contributor.advisor":["Arroll, B","Elley, C"],"dc:creator":["Falloon, Karen"],"dc:date.accessioned":["2014-05-18T23:16:45Z"],"dc:date.issued":["2014"],"dc:description.abstract":["Rationale: Insomnia is a common health problem for patients in primary care. A literature review conducted by the author concluded that cognitive behavioural therapy for insomnia (CBT-I) is effective but its use has been limited by the time and expense required for delivery. Sleep restriction, or restricting the time in bed, is one component of CBT-I, which could be delivered as a brief intervention during primary care consultations. A systematic review of sleep restriction as a stand-alone treatment for insomnia showed some benefit, but concluded that more evidence was required. Objective: To assess the effectiveness of simplified sleep restriction to improve sleep in primary insomnia. Design, Setting, and Participants: A randomised controlled trial involving adult patients with persistent primary insomnia recruited from general practice clinics in Auckland, New Zealand between 2009 and 2012. Intervention: Intervention patients received 20 minutes of sleep hygiene advice and “simplified sleep restriction” instructions at an initial visit with a general practitioner and 14 minutes of advice and a “sleep self-adjustment algorithm” at two weeks. Control patients received sleep hygiene advice alone at both visits. Main outcomes: The primary outcomes were change in sleep quality at six months as measured by the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and sleep efficiency. Proportion reaching a pre-defined “treatment response” was calculated using PSQI and sleep efficiency. Secondary outcomes included sleepiness, fatigue, sleep-onset latency, wakefulness after sleep onset, total sleep time, depression and anxiety. Potential adverse events (excessive sleepiness, accidents, hospitalisations, physiological parameters) were monitored. Results: Ninety-seven patients were recruited and 94 (97%) completed the study. Simplified sleep restriction led to significantly improved PSQI scores (6.2 vs 8.4, p < 0.001), ISI scores (8.6 vs 11.1, p = 0.001); sleep efficiency (difference between mean changes 2.2%, p = 0.006) and sleep onset latency (difference between mean changes -6.1 minutes, p = 0.04) as measured by actigraphy; and a reduction in fatigue (difference between mean changes -2.3 units, p = 0.04) compared with control. Simplified sleep restriction also produced higher rates of “treatment response” (67% [28/42] vs 41% [20/49]), with an adjusted odds ratio of 2.7 (95% CI, 1.1 to 6.5; p = 0.03). There were no significant differences in other outcomes or adverse effects. Conclusions and Relevance: Simplified sleep restriction is a practical, effective intervention for chronic insomnia in adults suitable for the primary care setting."],"dc:identifier.uri":["https://hdl.handle.net/2292/22116"],"dc:publisher":["ResearchSpace@Auckland"],"dc:rights":["Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher."],"dc:rights.uri":["https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm"],"dc:title":["Refresh. Restriction For Reorganising Sleep Habit: A randomised controlled trial of simplified sleep restriction for primary insomnia in the primary care setting"],"dc:type":["Thesis"],"thesis:degree_level":["Doctoral"],"thesis:degree_name":["PhD"],"thesis:institution_name":["The University of Auckland"]},"updated_at":"2026-07-24T01:07:07Z"}