INSOMNIA
Insomnia is a common sleep disorder characterized by difficulty falling asleep, staying asleep, or both. Insomnia can have a significant impact on a person's quality of life and can lead to daytime fatigue, difficulty concentrating, and an increased risk of accidents.
Cognitive-behavioral therapy for insomnia (CBT-I) is a form of therapy that has been shown to be effective in treating insomnia. CBT-I focuses on changing the thoughts and behaviors that are contributing to insomnia.
One of the core components of CBT-I is sleep restriction therapy. This involves setting a consistent sleep schedule, going to bed and waking up at the same time every day, and limiting the amount of time spent in bed to the amount of time actually spent sleeping. By limiting the time in bed, the body begins to associate the bed with sleep, making it easier to fall asleep.
Another component of CBT-I is stimulus control therapy. This strengthens the link between bed and sleep: going to bed only when sleepy, using the bed only for sleep and sex, getting out of bed when unable to sleep, and getting up at the same time every morning. Good sleep hygiene, such as keeping the bedroom dark, quiet, and cool and avoiding screens before bed, supports these changes.
Cognitive therapy is also an important component of CBT-I. This involves identifying and changing negative thoughts and beliefs about sleep that may be contributing to insomnia.
Research has shown that CBT-I is effective in treating insomnia. Meta-analyses have found that CBT-I is more effective than no treatment (Trauer et al., 2015) and that behavioral treatment produces short-term results similar to sleep medication (Smith et al., 2002). Another study found that for people with both depression and insomnia, adding CBT-I to antidepressant medication improved both sleep and depression outcomes (Manber et al., 2008).
CBT-I is a safe and effective treatment for insomnia and can be used alone or in combination with medication. If you are experiencing symptoms of insomnia, it is important to talk to a qualified mental health professional to determine the best course of treatment for you.
References:
Trauer, J. M., Qian, M. Y., Doyle, J. S., Rajaratnam, S. M. W., & Cunnington, D. (2015). Cognitive behavioral therapy for chronic insomnia: A systematic review and meta-analysis. Annals of Internal Medicine, 163(3), 191–204. https://doi.org/10.7326/M14-2841
Smith, M. T., Perlis, M. L., Park, A., Smith, M. S., Pennington, J., Giles, D. E., & Buysse, D. J. (2002). Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia. American Journal of Psychiatry, 159(1), 5–11. https://doi.org/10.1176/appi.ajp.159.1.5
Manber, R., Edinger, J. D., Gress, J. L., San Pedro-Salcedo, M. G., Kuo, T. F., & Kalista, T. (2008). Cognitive behavioral therapy for insomnia enhances depression outcome in patients with comorbid major depressive disorder and insomnia. Sleep, 31(4), 489–495. https://doi.org/10.1093/sleep/31.4.489
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