0418 Blinded Hypnotic Tapering Promotes Hypnotic Discontinuation
Bibliographic record
Abstract
Many hypnotic users make repeated unsuccessful attempts to discontinue their hypnotics. This study is testing blinded tapering protocols to reduce anxiety and help patients discontinue their hypnotics. This study is enrolling users of benzodiazepine and benzodiazepine receptor agonists. Enrollees complete a two-week baseline including sleep diaries, actigraphy, the Insomnia Severity Index (ISI) and Benzodiazepine Withdrawal Questionnaire (BWQ). They then complete 4 sessions of cognitive behavioral insomnia therapy (CBTI). Subsequently they are randomized to one of three 20-week, double-blinded tapering protocols wherein their medication dosage is either reduced by 25% or 10% every two weeks, or remains unchanged (CTRL). During tapering, all enrollees are seen biweekly by the study physician for support and guidance. At the end of the 20-week period the study blind is eliminated and those who completed one of the two tapering protocols enter a 3-month follow-up period whereas CTRL participants are offered an open label taper before completing follow-up. A total of 60 (M age = 55.8 ± 12.6 yrs.; 37 women) hypnotic users have been enrolled and started treatment. Thirty-eight have completed the CBTI phase, 22 have reached the end of the tapering, and 14 have completed the 3 month follow-up. Baseline ISI scores suggested moderately severe insomnia complaints (ISI=15.9 ± 0.73). These scores declined to the sub-clinical range by the post CBTI (10.92 ± 0.78) and tapering (9.50±.75) phases and into the normative range by follow-up (7.64 ± 1.65). BWQ scores remained fairly stable from baseline (3.00 ± 0.45) to post CBTI (3.51±.68) but declined by the end of tapering (1.67 ± 0.81). Of the 14 who completed one blind tapering protocols, 12 (86%) totally discontinued their medication use by the end of tapering whereas none in the CTRL group had chosen to do so. At follow-up 7 of 9 (78%) who completed blinded tapering remained medication free whereas 2 of 5 (40%) in the CTRL who underwent open-label tapering remained medication free. CBTI combined with blinded hypnotic tapering seems a promising treatment approach to help hypnotic users overcome their medication dependence and improve insomnia symptoms. National Institute of Drug Abuse, R34 DA042329-01.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".