A drug used to keep narcoleptics awake may also help insomniacs sleep better, Sydney researchers hope.
Scientists at the Woolcock Institute of Medical Research are investigating whether a popular wakefulness drug could be used to make an important insomnia treatment, sleep restriction therapy, more effective. The trial, a world-first, could hand Australia’s 1.5 million insomniacs a better, more appealing treatment plan to get them snoozing through the night.
“Sleep restriction therapy is one of the best treatments we have for people with insomnia but sadly the side effects – extreme daytime sleepiness – make it difficult for patients to stick to,” explains Study Doctor and Sleep Specialist Daniel Judge. “If we can show that using a wakefulness-promoting drug in the day improves side effects of sleep restriction therapy then the treatment will become far easier for patients to use.”
Studies estimate 13 to 33 per cent of the adult population have insomnia, defined as difficulty falling asleep, staying asleep, or both. Sedatives are the most common treatment but they should only be used short term and may not treat the underlying cause of the condition.
Delivered by a sleep psychologist, sleep restriction therapy (SRT) is a non-drug option in which time in bed is restricted each night. The partial sleep deprivation makes you more tired the next night, setting you up for a deeper sleep which is gradually lengthened as the therapy progresses.
“The concept of reducing sleep in order to increase it might seem absurd but studies show it’s actually just as effective as sleeping tablets at getting you sleeping better,” Dr Judge says. “The trouble is you feel so groggy and sleepy during the day that so many people drop out of treatment before they see the benefits.”
The Woolcock team is enlisting 30 people with insomnia to trial the therapy alongside the drug armodafinil, marketed as Nuvigil, which is approved in Australia to treat patients with excessive sleepiness associated with narcolepsy, obstructive sleep apnea or shift work disorder.
“If it works to keep these patients awake during the day then we’re hoping it will have the same alerting effect on people with insomnia, ultimately making it easier for them to recover from their condition,” Dr Judge says.
Volunteers will take the drug daily over four weeks alongside sleep restriction therapy. Sleep diaries and actiwatches will be used to monitor sleep and track progress.
It is not a placebo-controlled trial so all participants will receive the active drug. If results are positive, the Woolcock will run a much larger study before specialists could consider widespread use of armodafinil for insomnia, Dr Yee says.
If you are an insomnia patient seeking treatment, contact the study coordinator Parisa Hassan on (02) 9114 0469, email firstname.lastname@example.org, or visit https://woolcock.org.au/new-2/do-you-have-insomnia-2 to register your interest.