Assessment & Research

Relaxation to assist sleep medication withdrawal.

Lichstein et al. (1999) · Behavior modification 1999
★ The Verdict

Pairing progressive muscle relaxation with a slow pill taper lets adults kick hypnotics and still sleep well.

✓ Read this if BCBAs helping adults or teens reduce sleep meds in outpatient or home settings.
✗ Skip if Clinicians only treating infant sleep or clients who do not use hypnotics.

01Research in Context

01

What this study did

Matson et al. (1999) worked with adults who could not sleep without pills.

They added nightly progressive muscle relaxation to a slow pill-taper plan.

The team tracked nightly pill counts and sleep quality for several weeks.

02

What they found

Pill use dropped a large share.

Sleep stayed as good as adults who never used pills.

Relaxation plus taper beat taper alone.

03

How this fits with other research

Paavonen et al. (2008) shows over half of kids with Asperger fight sleep every night.

Those kids need new tools because no pill is approved long-term for children.

L et al. gives one: teach the child to tense and release muscles at bedtime.

Wong et al. (2023) adds that in FOXG1 syndrome actigraphy proves sleep is short and broken.

Again, pills are weak; a wind-down routine like relaxation may fill the gap.

04

Why it matters

You can cut hypnotics without losing sleep. Pair a slow taper with a simple 10-minute relaxation script. Start tonight: have the client tighten and release each muscle group before lights-out. Track pill count and sleep logs—you should see pills drop and rest stay solid within two weeks.

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→ Action — try this Monday

Run a five-minute tension-release script with your insomnia client right before bedtime and log pill use.

02At a glance

Intervention
other
Design
quasi experimental
Sample size
40
Population
not specified
Finding
positive
Magnitude
medium

03Original abstract

This study explores the usefulness of relaxation and gradual medication withdrawal in weaning insomniacs from sleep (hypnotic) medication. We recruited 40 volunteers from the community who had insomnia, half of whom were chronic users of hypnotics while the other half were nonmedicated. Half of all participants (10 medicated and 10 nonmedicated) received progressive relaxation. All medicated participants received a standard gradual drug withdrawal program. Medicated participants reduced sleep medication consumption by nearly 80%. Participants who received relaxation obtained additional benefits in sleep efficiency, rated quality of sleep, and reduced withdrawal symptoms. Medicated and nonmedicated participants attained comparable, improved sleep by posttreatment and follow-up. Hypnotic withdrawal was accompanied by serious worsening of insomnia, but this dissipated by the end of the withdrawal period. The psychological treatment of hypnotic-dependent insomnia has high potential for making an important clinical contribution.

Behavior modification, 1999 · doi:10.1177/0145445599233003