Adults with chronic illnesses who have trouble sleeping can benefit from a behavior modification program, according to a study conducted by sleep researchers at Rush-Presbyterian-St. Luke's Medical Center in Chicago.

In a study published in the journal Psychology and Aging, three groups consisting of 38 older adults with chronic illnesses such as arthritis, cardiovascular disease, or lung disease were randomly assigned to one of three treatment groups.

One group received classroom cognitive behavioral treatment (CBT), the second group was given home audio relaxation treatment (HART), and the third group received delayed treatment.

The behavioral classroom intervention consisted of eight-hour weekly group sessions that train individuals to reset their "sleep clock" by adhering to a regular sleep period, curtailing daytime naps, avoiding activities that make it difficult to fall asleep, and to staying in bed only when drowsy or sleepy.

The HART program consisted of seven commercially produced audiotape recordings derived from a program created for the U.S. Air Force to train pilots and shift workers to sleep better. HART was used over a period of six weeks and the tapes combined progressive muscle relaxation, breathing relaxation, cognitive relaxation, cognitive retraining and nature sounds. It also included instruction in techniques that are similar to those employed in the CBT intervention.

The delayed treatment control group participants completed three in home assessments at intervals that matched the other treatment groups, and offered HART intervention at the end of the six months.

After a period of four months the researchers measured sleep efficiency, time awake after sleep onset and total time in bed, and found 54 percent of the CBT group had clinically significant sleep improvements, while 39 percent in the HART group showed statistically significant changes, and 6 percent in the control group improved.

Bruce Rybarczyk, PhD, an associate professor at Rush Medical College, and colleagues measured the participants' sleep experiences using a number of methods, including sleep logs kept by each participant and actigraphy, which is a wrist monitor that records intensity and frequency of movement.

He pointed out the results of the study show that seniors with chronic illness may be able make substantial improvements in their sleep without resorting to medication.

"Regardless of which method works best, it is hoped that seniors with these chronic illnesses can better control their own sleep without introducing medications as many of these patients already take several drugs to provide care for their other medical conditions," said Rybarczyk. He also noted that "there is a strong preference among older adults to use sleep medications as a last resort and on a short-term basis only. These techniques will give older adults an important new option."