Researchers found that 73.4% of older adults using a masked taper combined with cognitive behavioral therapy for insomnia successfully discontinued benzodiazepine receptor agonists, compared to 58.6% with standard tapering methods, according to a recent study.
A randomized clinical trial evaluated the efficacy of a masked taper combined with cognitive behavioral therapy for insomnia (CBTI) in facilitating benzodiazepine receptor agonist discontinuation. The study, published in JAMA Internal Medicine, enrolled 188 adults aged 55 years or older who had been using benzodiazepine receptor agonists for insomnia. Participants were randomly assigned to either a masked taper with an augmented CBTI approach or an open taper with standard CBTI.
At six months, benzodiazepine receptor agonist discontinuation rates were higher in the masked taper group (73.4%) compared to the open taper group (58.6%) (odds ratio [OR], 1.95; 95% confidence interval [CI], 1.03-3.70; P = .04). Additionally, at one-week post-treatment, 88.4% of participants in the masked taper group had discontinued benzodiazepine receptor agonists, compared to 67.4% in the open taper group (OR, 3.68; 95% CI, 1.67-8.12; P = .001).
The frequency of benzodiazepine receptor agonist uses also declined more in the masked taper group during the first week post-treatment, with participants reporting a reduction of 1.31 nights per week (95% CI, -2.05 to -0.57; P < .001) compared to the standard CBTI group.
Insomnia severity improved in both groups with no significant difference at six months (P = .88). Both treatments led to clinically meaningful reductions in insomnia severity, with no major adverse events. Reported events included falls (two in the masked taper plus cognitive behavioral therapy-augmented program [MTcap] group, one in the standard CBTI plus supervised (unmasked) gradual taper [SGT] group), chest tightness/respiratory illness (one in MTcap), and dyspnea (one in SGT), but no serious adverse events or hospitalizations occurred.
Full disclosures can be found in the published study.