Insomnia
Are you having trouble sleeping? Is it impacting your ability to function during the day? Unfortunately, difficulty with sleeping can become a regular problem for many of us. This might include having trouble falling asleep, staying asleep, or getting restful sleep more nights than not. When this issue becomes chronic, it is referred to as Insomnia.
Having trouble sleeping is a common issue that many of us experience from time to time. You are not alone. According to the American Academy of Sleep Medicine, up to 35% of adults express complaints of insomnia. Insomnia is most common in groups such as older adults, individuals experiencing a great amount of daily stress, and those suffering from certain medical and mental health problems such as COPD, chronic pain, substance use, anxiety, depression, panic disorder, and PTSD. Nighttime symptoms of insomnia include difficulty initiating and/or maintaining sleep throughout the night and into the morning, and/or experiencing episodes of nonrestorative sleep.
Symptoms of Insomnia
Insomnia typically includes several consequences as a result of poor sleep. It often leads to functional impairment during your hours of wakefulness. Daytime symptoms of insomnia, that contribute to this functional impairment include fatigue, problems with attention, concentration, or memory, decreased performance at school or work, increased anxiety, depression, moodiness, or irritability, decreased energy or motivation, and concern or frustration about your sleep. There may also be physical symptoms present, like tension, headaches, or gastric distress. If it takes you more than 30 minutes to fall asleep and you experience some of the symptoms listed above, you may be suffering from Insomnia.
Untreated chronic insomnia often leads to sleep deprivation. Sleep deprivation is of major concern as it can result in potentially dangerous daytime sleepiness and can also increase the risk of developing depression, anxiety, high blood pressure, heart attack, stroke, obstructive sleep apnea, type 2 diabetes, obesity, and conditions that involve psychosis.
How do you treat sleep difficulties or Insomnia?
Fortunately, there is effective therapy for Insomnia and other sleep difficulties. Most common among these therapies is Cognitive Behavioral Therapy for Insomnia (CBT-I) along with sleep hygiene education. This therapy is particularly effective because it targets our daily habits, and particularly our nighttime habits, which play an incredibly important role in how we sleep. CBT-I and sleep hygiene help to incorporate healthier behaviors to promote better sleep along with developing healthy attitudes and changing unhelpful thinking about sleep.
A particularly encouraging note about CBT-I: Research shows that CBT-I has more long-term effectiveness for treating Insomnia than medical treatment (most commonly sleep medication).
How do we develop sleep troubles or Insomnia?
Many factors predispose us to develop Insomnia, including:
- A family history of anxiety or sleep difficulties.
- Being a light sleeper/being easily startled.
- Having inconsistent bedtimes.
The above factors, combined with immediate stressors (for example, stress from psychological or emotional difficulties, changed sleep schedule due to a new job or other life factors, or sleep disturbances due to a medical condition or treatment) can work together to develop and maintain sleep difficulties. Combine this with unhelpful coping habits (like daytime napping, drinking too much caffeine, or spending too much time in bed when you’re not sleeping) and difficulty sleeping can become a chronic issue.
How do you treat sleep difficulties or Insomnia?
Fortunately, there are effective therapy methods for Insomnia and other sleep difficulties. Medication treatment for insomnia, particularly the use of sedative or hypnotic medications, is commonly used to treat insomnia. While pharmacological interventions have been shown to be effective in the treatment of insomnia, they are not generally recommended for long-term use, or as a 1st line treatment for insomnia due to the potential risks and common negative side effects. These include the potential for tolerance development, psychological dependence, the suppression of REM sleep, as well as other possible negative physical and psychiatric consequences.
Cognitive Behavioral Therapy for Insomnia
The limited effectiveness of pharmacological treatment for the treatment of insomnia, coupled with the potential risks associated with their long-term usage, allows for psychological treatment to be the preferred way to treat insomnia, both by medical professionals and patients. Though several psychological interventions have been shown to be effective in the treatment of insomnia, Cognitive Behavioral Therapy for Insomnia (CBT-I) paired with sleep hygiene education has generally been demonstrated to be the most effective.
This therapy is particularly effective because it targets our daily habits, particularly our nighttime habits, which play an incredibly important role in how we sleep. CBT-I and sleep hygiene help to incorporate healthier behaviors to promote better sleep along with developing healthy attitudes and changing unhelpful thinking about sleep.
What will I learn in CBT-I and Sleep Hygiene Training?
By participating in CBT-I and sleep hygiene training, you can expect to learn the following:
- How to keep a sleep diary to track how you sleep and how your sleep might be affected by your daily and nightly habits.
- What habits help promote regular, restful sleep.
- What habits you should avoid to help improve sleep.
- How to effectively implement these healthy habits while eliminating these unhelpful habits.
- What to do if you cannot fall asleep or stay asleep in the middle of the night.
- Relaxation techniques to use throughout the day and especially in the hours before bedtime.
- How to identify and adjust unhelpful thinking that often contributes to our stress and frustration about sleep.
Cognitive Behavioral Therapy for Insomnia (CBT-I) At The Center for the Treatment of Anxiety and Mood Disorders
When available, as indicated by the American College of Physicians and the American Academy of Sleep Medicine, CBT-I is recommended as the 1st line treatment for insomnia. CBT-I is as effective or more effective compared to pharmacological interventions in the treatment of insomnia, with no side effects, fewer episodes of relapse, and a tendency for sleep to continue to improve long past the end of treatment. CBT-I is a multi-component, short-term, treatment that targets poor sleep quality and difficulties initiating and/or maintaining sleep. This is done using several behavioral and cognitive strategies that are applied to combat the perpetuating factors that maintain the cycle of insomnia.
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