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Record W2936640905 · doi:10.1093/sleep/zsz067.407

0408 A Blinded Hypnotic Tapering Approach for Hypnotic discontinuation

2019· article· en· W2936640905 on OpenAlexaff
Jack D. Edinger, Frederick S. Wamboldt, Kristen E. Holm, Rachel L. Johnson, Bryan Simmons, Sheila C. Tsai, Charles M. Morin

Bibliographic record

VenueSLEEP · 2019
Typearticle
Languageen
FieldPsychology
TopicSleep and related disorders
Canadian institutionsUniversité Laval
Fundersnot available
KeywordsTaperingDiscontinuationMedicineHypnoticAnxietyInsomniaAnesthesiaRandomized controlled trialSurgeryPsychiatry

Abstract

fetched live from OpenAlex

Hypnotic users commonly make unsuccessful attempts to discontinue their hypnotics. This study tested a blinded tapering approach to reduce anxiety and help patients discontinue their hypnotics. This study enrolled 78 (M age = 55.2 ± 12.8 yrs.; 65.4% women) users of benzodiazepine and benzodiazepine receptor agonists. Enrollees completed baseline measures including the Insomnia Severity Index (ISI). They then completed 4 sessions of cognitive behavioral insomnia therapy (CBTI). Subsequently they were randomized to one of three 20-week, double-blinded tapering protocols wherein their medication dosage was either reduced by 25% or 10% every two weeks, or remained unchanged (CTRL). During tapering, all enrollees were seen biweekly by the study physician for support and guidance. At the end of the 20-week period the study blind was eliminated and those who completed one of the two blinded tapering protocols entered a 3-month follow-up period, whereas CTRL participants are offered an open label taper before completing the follow-up. Baseline ISI scores (ISI=18.07±0.58) showed that the total sample entered the trial with moderately severe insomnia complaints despite almost nightly hypnotic use. These scores declined into the mild range after CBTI (10.19±0.53) and tapering (9.62±.63) and approached the normative range by follow-up (7.59±1.05). Of the 45 who completed one of the blinded tapering protocols to date, 39 (86.7%) totally discontinued their medication use by the end of the 20-week tapering phase whereas 12 (75%) of 16 in the CTRL group discontinued hypnotic use by the end of their open label tapering. At follow-up 22 of 30 (73.3%) who completed blinded tapering remained medication free whereas only 5 of 14 (35.7%) in the CTRL group 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, Grant # 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 distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Other design · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.684
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.001

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.

Opus teacher head0.022
GPT teacher head0.282
Teacher spread0.261 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designOther design
Domainnot available
GenreEmpirical

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".

Quick stats

Citations2
Published2019
Admission routes1
Has abstractyes

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