To investigate the synergistic effect of dexmedetomidine and cognitive behavioral therapy (CBT) on chronic insomnia. Forty-six chronic insomnia patients were selected and randomly assigned to the CBT group (CBT-I) or the CBT combined with dexmedetomidine (CBT-I + DEX) group. The sleep indexes and polysomnographic parameters were assessed before treatment, 4 weeks after treatment, and 8 weeks after treatment. The daily sleep conditions were recorded during the entire treatment course. Eight patients in the CBT-I group quit treatment, with a success rate of 65.2 %, and two patients in the CBT-I + DEX group quit treatment, with a success rate of 91.3 %, revealing a significant difference between the two groups (P < 0.05). At 4 and 8 weeks after treatment, the soma-arousal level was significantly decreased in the CBT-I + DEX group compared with the CBT-I group (P < 0.01), but no significant difference in the cognitive arousal. Polysomnographic monitoring results show that the sleep time at non-REM stage 3 (N3) and the total sleep time in the CBT-I + DEX group was longer than the CBT-I group after 4 weeks of treatment (P < 0.05). The number of awakenings, sleep latency, REM sleep latency and sleep efficiency were significantly improved in both groups at the end of treatment (P < 0.05), but the total sleep time was not obviously increased in both groups. Dexmedetomidine hydrochloride-induced sleep effectively reduced the patients’ arousal level, prolonged deep sleep, reduced the degree of daytime sleepiness, and improved the success rate of CBT.
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Cognitive behavioral therapy
Dexmedetomidine induced sleep
Stimulus control therapy
Sleep hygiene education
Insomnia Severity Index
Pre-Sleep Arousal Scale
The Hyperarousal Scale
The Pittsburgh Sleep Quality Index
The Epworth Sleepiness Scale
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The study was supported by the funding of new technology research about regulating center nerve hyperarousal state and correcting accumulated sleep debt (No. 12BJZ51).
Conflict of interest
There is no conflict of interest declared.
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Li, X., Jiang, X., Liu, Y. et al. Efficacy of dexmedetomidine with cognitive behavioral therapy for treating chronic insomnia related to conditioned arousal: a randomized controlled trial. Sleep Biol. Rhythms 14, 75–85 (2016). https://doi.org/10.1007/s41105-015-0025-7
- Conditioned arousal
- Chronic insomnia
- Cognitive behavioral therapy
- Sleep induction