MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

Insomnia is a ‘gold standard’ indication for alternative therapies of all types. In fact, it is difficult to find a single of these treatments that are not being touted for this indication. Consequently, it has become a nice little earner for alternative therapists (hence ‘gold standard’).

But how good is the evidence suggesting that any alternative therapy is effective for insomnia?

Whenever I have discussed this issue on my blog, the conclusion was that the evidence is less than convincing or even negative. Similarly, whenever I conducted proper systematic reviews in this area, the evidence turned out to be weak or negative. Here are four of the conclusions we drew at the time:

“But this ERNST fellow cannot be trusted, he is not objective!”, I hear some of my detractors shout.

But is he really?

Would an independent, high-level panel of experts arrive at more positive conclusions?

Let’s find out!

This European guideline for the diagnosis and treatment of insomnia recently provided recommendations for the management of adult patients with insomnia. The guideline is based on a systematic review of relevant meta-analyses published till June 2016. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) system was used to grade the evidence and guide recommendations.

The findings and recommendations are as follows:

  • Cognitive behavioural therapy for insomnia is recommended as the first-line treatment for chronic insomnia in adults of any age (strong recommendation, high-quality evidence).
  • A pharmacological intervention can be offered if cognitive behavioural therapy for insomnia is not sufficiently effective or not available. Benzodiazepines, benzodiazepine receptor agonists and some antidepressants are effective in the short-term treatment of insomnia (≤4 weeks; weak recommendation, moderate-quality evidence). Antihistamines, antipsychotics, melatonin and phytotherapeutics are not recommended for insomnia treatment (strong to weak recommendations, low- to very-low-quality evidence).
  • Light therapy and exercise need to be further evaluated to judge their usefulness in the treatment of insomnia (weak recommendation, low-quality evidence).
  • Complementary and alternative treatments (e.g. homeopathy, acupuncture) are not recommended for insomnia treatment (weak recommendation, very-low-quality evidence).

I think, I can rest my case.

12 Responses to Insomnia? Avoid alternative therapies!

  • I thought I’d reply to this even though it will cause many readers to get irate with me and probably experience insomnia.

    Traditional doctors who are in bed with Big Pharma will recommend drugs with mysterious chemical names to cure insomnia. It makes them a lot of money after all. But for those who are open-minded to alternative therapies, which work with energy, I recommend the Emotional Freedom Technique (EFT) at http://www.emofree.com .

    At least listen to what this once sceptical doctor wrote at https://www.emofree.com/other-physical-issues/insomnia-sleep/insomnia-pat-article.html . She doesn’t explain the tapping technique for clearing energy from the body’s meridian (energy) pathways as people on the website already know how to do this.

    If you would like more evidence, then go to https://www.emofree.com/component/com_custom_cloud_search/view,search/

    Please don’t ask me again for scientific pharmaceutical research reports about this because Big Pharma would not carry out research into healing, which will reduce their profits. They make money from selling expensive drugs, not by telling people how to cure their own insomnia and illnesses.

    Traditionalists may be very disturbed by EFT because it works, and it is an energy healing technique. People on this Blog do not like to believe that you can heal with energy healing. You can find out on many websites just how effective it is.

    • “…Big Pharma would not carry out research into healing, which will reduce their profits…”
      this is why BIG ALT MED needs to do the research or abstain from making bogus claims.

    • @Peter McAlpine

      You wrote

      At least listen to what this once sceptical doctor wrote at https://www.emofree.com/other-physical-issues/insomnia-sleep/insomnia-pat-article.html

      For the benefit of other readers of this blog who don’t bother to check the link, the lady concerned has a PhD: she’s not a medical doctor, as the comment seems to suggest. (BTW I have nothing against the PhD qualification: I have one myself; but I never use the title to imply I’m medically qualified.)

      People on this Blog do not like to believe that you can heal with energy healing.

      For the benefit of those of us too thick to understand, you might at least explain what you understand ‘energy healing’ to be. Many folk on this website don’t already know the tapping technique for clearing energy from the body’s meridian (energy) pathways. Please provide either a coherent explanation or link to something other than a website’s home page so we can be educated.

      You can find out on many websites just how effective it is.

      But I already found out on thousands of websites how very effective acupuncture, shiatsu, gua sha, chiropractic, homeopathy, reflexology, aromatherapy, reiki, craniosacral therapy, healing touch, iridology and a lot of other techniques are claimed to be for healing. Why are the websites you link to somehow more credible than all these others?

    • Peter,

      I am not irate and I shall lose no sleep as a consequence of reading what you said.

      You want to go after Big Pharma? Fine. You do that. I shall stick to the topic, which happens to be about the use of Alt Med for insomnia. Big or small, Alt Med makes money by selling Alt Med.

      Being open-minded is no good if your brain falls right out in front of your feet and you stomp all over it.

      You ask me to listen to someone with a PhD.

      Check out the qualifications of the many, many members of the various Committees and groups comprising the European Sleep Research Society. The organisation responsbile for the guideline linked to by Edzard.

      You might spot some affinities with Big Pharma in amongst them, not apparent to me. In any case, they all seem to be highly qualified in the specific medical science of sleep and its disorders.

      The guideline was drawn up by a score of medical specialists in sleep disorders after a wide-ranging search for and analysis of the available medical evidence regarding the effectiveness of a gamut of available treatments.

      Alt Meds may be very disturbed because of all the many treatments available for insomnia, AM was found to be the most useless.

    • “Cognitive behavioural therapy for insomnia is recommended as the first-line treatment for chronic insomnia in adults of any age (strong recommendation, high-quality evidence)”.

      Big Pharma should be happy with that recommendation. CBT is a great money earner for them.

  • … alternative therapies, which work with energy…

    What form of energy is this? How can it be detected and measured?

    • What kind of energy? Clearly kinetic if one is tapping with one’s fingers.

      Oh, the kind being cleared! Obviously Quantum Energy, what else?

      • I think we can be reasonably certain that no energy healer has ever managed to ‘unblock’ human energy at the quantum level, because doing so would suddenly release circa 5.7 exajoules (5.7 quintillion joules) — nearly four times the energy of the 2011 Tōhoku earthquake and tsunami in Japan!

        • How else do you explain novae?

          Luckily, the quantum entanglement gets the patient away from earth by a super-luminal distortion of the space-time fabric.

  • Coincidentally, Mark Taylor, Chief Executive of the homeopaths’ trade body, the Society of Homeopaths, Tweeted this morning:

    Study: Homeopathic Remedies Improve Sleep Patterns – Homeopathy Plus

    …linking to this article: Study: Homeopathic Remedies Improve Sleep Patterns. The article concluded

    The study showed that compared to placebo, NREM and total sleep time was significantly increased with the use of the homeopathic remedies.

    The original study, however, concluded:

    The study demonstrated the feasibility of using in-home, all-night sleep recordings to study homeopathic remedy effects. Findings are similar though not identical to those reported in animals with the same remedies. Possible mechanisms include initial disruption of the nonlinear dynamics of sleep patterns by the verum remedies.

    Compare and contrast, as they say…

  • Interesting, but, I don’t know what we are talking about.
    The abstract of the article refers to ‘insomnia’, but does not define that term.
    I take it we are to refer to 2017 ICD-10-CM Diagnosis Code G47.0.
    Agreed?

    In which case we are considering how the brain functions, and that requires consideration of many pychological and physiological mechanisms including conditions of anxiety, stress, depression, cognitive dissonance, predisposition etc.

    Are we not agreed, camistry in all its manifestations seeks to provide care in two ways: (i) the specifics of the pillules, pummelling, pricking, and preternatural powers (for which there is no plausible reproducible scientific evidence – or it would be ‘medicine’); (ii) the attentions of an empathic practitioner and positive therapeutic patient/practitioner relationship. Bedside manner, TLC if you will.
    It ‘works’ . Patients ‘feel better’ (in the case of 2017 ICD-10-CM Diagnosis Code G47.0 – when they wake up!)

    It is surprising these studies did not show a greater effect of applying camistry/alternative therapies.
    Have camists lost their touch?

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