Behavioral economics strategies for promoting adherence to sleep interventions. (October 2015)

• Record Type: Journal Article
• Authors: Stevens, Jack
• Is Part Of: Sleep medicine reviews. Volume 23(2015)
• Page Start: 20
• Page End: 27
• Publication Date: 2015-10
• Subjects: Behavioral economics -- Sleep -- Cognitive behavioral therapy -- Continuous positive airway pressure; BE behavioral economics -- CBT cognitive behavioral therapy -- CPAP continuous positive airway pressure -- OSA obstructive sleep apnea -- EMR Electronic Medical Record; Sleep disorders -- Periodicals; Sleep Disorders -- Periodicals; Sommeil, Troubles du -- Périodiques; Electronic journals; 616.8498
• DOI: 10.1016/j.smrv.2014.11.002
• Languages: English
• ISSNs: 1087-0792

Abstract

Summary: Cognitive-behavioral treatment for insomnia and continuous positive airway pressure therapy for obstructive sleep apnea are among the most efficacious sleep interventions. Unfortunately, adherence levels are disappointingly low for these interventions. Behavioral economics offers a promising framework for promoting adherence, often through relatively brief and straightforward strategies. The assumptions, goals, and key strategies of behavioral economics will be introduced. These strategies include providing social norms information, changing defaults, using the compromise effect, utilizing commitment devices, and establishing lottery-based systems. Then, this review will highlight specific behavioral economic approaches to promote patient adherence for three major sleep interventions: 1) behavioral treatment for pediatric insomnia, 2) cognitive-behavioral treatment for adult insomnia, and 3) continuous positive airway pressure for obstructive sleep apnea. Next, behavioral economic strategies will be discussed as ways to improve health care provider adherence to clinical practice guidelines regarding appropriate prescribing of hypnotics and ordering sleep-promoting practices for hospitalized inpatients. Finally, possible concerns that readers may have about behavioral economics strategies, including their efficacy, feasibility, and sustainability, will be addressed.