Efficacy of a Paradoxical Intervention in the Treatment of Sleep-Onset Insomnia in Women During and After the Climacteric Stage: A Pilot Study

Paradoxical interventions involve asking patients to maintain or exaggerate the symptoms they wish to eliminate, with the aim of reducing them. These techniques received empirical support, particularly in the treatment of sleep-onset insomnia, during the 1980s. However, changes in sleep habits over recent decades warrant further research on their current applicability. This article reports a pilot study involving 26 women (aged 40–70) with significant difficulty initiating sleep, who were randomly assigned to either a paradoxical or a non-paradoxical treatment; a prior waiting period was also used as a waitlist control. Both treatments produced statistically significant improvements in insomnia scores between pre- and post-treatment, with no significant differences between groups. These findings suggest that paradoxical interventions may be effective for the current treatment of sleep-onset insomnia and support the need for randomized clinical trials with larger samples.