Trial reportJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine2020
Effects of trazodone versus cognitive behavioral therapy in the insomnia with short sleep duration phenotype: a preliminary study.
Trial report in Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01348542 (Efficacy of Trazodone vs. Cognitive Behavioral Therapy in Patients With Chronic Insomnia Associated With Objective Short Sleep Duration), which is not on this map. Cited by 22 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Efficacy of Trazodone vs. Cognitive Behavioral Therapy in Patients With Chronic Insomnia Associated With Objective Short Sleep Duration
Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- The wake of addiction: Pharmacological strategies for sleep disturbances in stimulant use disorders, a systematic review.Drug and alcohol dependence · 2026Pooled it
- Initial treatment choices for long-term remission of chronic insomnia disorder in adults: a systematic review and network meta-analysis.Psychiatry and clinical neurosciences · 2024Pooled it
- Insomnia nosology: a systematic review and critical appraisal of historical diagnostic categories and current phenotypes.Journal of sleep research · 2023Pooled it
- Trial
- Mechanisms Linking Insomnia and Cardiometabolic Disease Risk.Arteriosclerosis, thrombosis, and vascular biology · 2026Review
- The effectiveness of Cognitive behavioral therapy for insomnia on sleep EEG hyperarousal: a multicentric polysomnographic study.Translational psychiatry · 2026Article
- Insomnia and Hypertension: Importance of Objective Phenotyping and Comorbidity with Sleep Apnea.Current hypertension reports · 2026Review
- Obstructive sleep apnea comorbid with insomnia symptoms and objective short sleep duration is associated with incident hypertension.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Article
- The Future of Insomnia Research-There's Still Work to Be Done.Journal of sleep research · 2025Review
- Insomnia Phenotypes, Cardiovascular Risk and Their Link to Brain Health.Circulation research · 2025Review
- Insomnia with objective but not subjective short sleep duration is associated with incident cardiovascular and/or cerebrovascular disease.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Sleep-EEG in comorbid pain and insomnia: implications for the treatment of pain disorders.Pain reports · 2023Article
- 2023 Guidelines on the Diagnosis and Treatment of Insomnia in Adults - Brazilian Sleep Association.Sleep science (Sao Paulo, Brazil) · 2023Review
- Should Trazodone Be First-Line Therapy for Insomnia? A Clinical Suitability Appraisal.Journal of clinical medicine · 2023Review
- IL-6 Enhances the Negative Impact of Cortisol on Cognition among Community-Dwelling Older People without Dementia.Healthcare (Basel, Switzerland) · 2023Article
- Long-term associations between objective sleep quality and quantity and verbal memory performance in normal cognition and mild cognitive impairment.Frontiers in neuroscience · 2023Article
- The underestimation of sleep duration phenotype is associated with better treatment response to cognitive behavior therapy for insomnia in patients with chronic insomnia: a preliminary study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2022Article
- Effects of electrostatic therapy on nighttime sleep and daytime symptoms in patients with chronic insomnia: Evidences from an open label study.Frontiers in neuroscience · 2022Article
- Effects of the Radix Ginseng and Semen Ziziphi Spinosae drug pair on the GLU/GABA-GLN metabolic cycle and the intestinal microflora of insomniac rats based on the brain-gut axis.Frontiers in pharmacology · 2022Article
- Trazodone Add-on in COVID-19-related Selective Serotonin Reuptake Inhibitor-resistant Post-traumatic Stress Disorder in Healthcare Workers: Two Case Reports.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2021Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesThe insomnia with objective short sleep duration phenotype is associated with increased risk for adverse health outcomes, physiological hyperarousal, and a blunted response to cognitive behavioral therapy for insomnia (CBT-I). Whether insomnia with objective short sleep duration responds better to pharmacological treatment compared to CBT-I has not been examined.
methodsParticipants included 15 patients with chronic insomnia (86.7% female), aged 45.3 ± 8.1 years. Eight patients were randomized to CBT-I and 7 to trazodone. Patients were examined with 2 weeks of actigraphy, salivary cortisol, and the insomnia severity index at 3 time points (pretreatment, 3-month posttreatment, and 6-month follow-up). Mixed between-within-subjects analysis of variance and univariate analysis of covariance were conducted to assess the impact of trazodone and CBT-I on patients' total sleep time, salivary cortisol, and insomnia severity index scores across the 3 time points.
resultsTrazodone, but not CBT-I, significantly lengthened total sleep time (when measured with actigraphy) both at posttreatment (51.01 minutes vs -11.73 minutes; P = .051; Cohen's d = 1.383) and at follow-up (50.35 minutes vs -7.56 minutes; P = .012; Cohen's d = 1.725), respectively. In addition, trazodone, but not CBT-I, showed a clinically meaningful decrease in salivary cortisol from pretreatment to posttreatment (-36.07% vs -11.70%; Cohen's d = 0.793) and from pretreatment to follow-up (-21.37% vs -5.79%; Cohen's d = 0.284), respectively. Finally, there were no differences on insomnia severity index scores between the trazodone and the CBT-I groups.
conclusionsThe current preliminary, open-label, randomized trial suggests that trazodone, but not CBT-I, significantly improves objective sleep duration and reduces hypothalamic-pituitary-adrenal axis activation, suggesting a differential treatment response in the insomnia with objective short sleep duration phenotype. CLINICAL
trial registrationRegistry: ClinicalTrials.gov; Name: Study of Trazodone & Cognitive Behavioral Therapy to Treat Insomnia; URL: https://clinicaltrials.gov/ct2/show/NCT01348542; Identifier: NCT01348542.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.