CBT: a new choice for insomnia treatment

[historyteach]

Insomnia treatment:
Cognitive behavioral therapy instead of sleeping pills

Your insomnia is more than just occasionally being unable to get a good night's sleep. It's a serious disorder, and until now, there were few safe, effective insomnia treatments.

Your insomnia may be caused by one or more underlying problems. You may have restless legs syndrome, sleep apnea or a serious medical condition that keeps you from getting restful sleep. And like a large number of people who have insomnia — 42 million by some estimates — you may have turned to sleeping pills for insomnia treatment.

What's so good about a good night's sleep?
Sleep is essential for your physical and mental well-being. When you're sleep-deprived, recovery from stress takes longer, and you're more likely to develop infections, high blood pressure, cardiovascular disease and diabetes. You may have problems with learning and memory, may be depressed and irritable, and apt to make mistakes on the job. You also have a higher risk of being in a motor vehicle crash — people with insomnia have twice as many car accidents as does the general population.

Natural sleep is best. It's physically restorative, and it usually provides enough dreaming time (REM sleep) to improve learning, memory and mood. But most sleep experts agree that there are times when sleeping pills, especially the relatively new class of drugs that includes zolpidem (Ambien), eszopiclone (Lunesta) and zaleplon (Sonata), may be of help.

Such times include periods of pain or grief, or when sleep loss affects your job performance. But though sleeping pills are a temporary aid and shouldn't be taken for more than a few days to a few weeks, some people take these drugs far longer — often every night for months. And some users may increase their dosage as the pills become less effective.

Especially when taken for long periods or in higher than normal doses, sleeping pills can cause serious problems that far outweigh their benefits. Among other side effects, sleeping pills can:

*Mask the real causes of poor sleep, such as depression, heart trouble, asthma and Parkinson's disease, and delay treatment of these disorders
*Interact with other medications or alcohol, often with serious, even deadly, results
*Cause next-day grogginess or rebound insomnia — an inability to sleep that's worse than the original problem
*Lead to high blood pressure, dizziness, weakness, nausea, confusion, short-term amnesia and bizarre behavior that goes far beyond traditional sleepwalking to include "sleep binge eating," "sleep shoplifting" and "sleep driving" — none of which the person remembers

Cognitive behavioral therapy: A new tool for treating insomnia
For years, people who spent their nights tossing and turning didn't have many choices. But now there is an insomnia treatment that's an alternative to pills, even for people with severe or chronic sleep problems. Called cognitive behavioral therapy (CBT), this relatively simple, short-term treatment has long been used to treat a range of problems, including depression, panic attacks, eating disorders and substance abuse. Now, it has also proved effective against insomnia. So effective, in fact, that for most people it works better than sleeping pills — with no side effects.

CBT can benefit nearly everyone, including older adults who have been taking sleep medications for years, people with physical problems such as restless legs syndrome, and those with primary insomnia, an intractable, lifelong inability to get enough rest. What's more, the effects seem to last — a year after CBT, most people still sleep soundly.

How does it work?
CBT is based on the idea that how you think affects the way you feel and behave. By changing your thought processes (cognition), the theory goes, your behavior also changes. When used as an insomnia treatment, CBT, which usually requires four to eight 30-minute sessions with a trained sleep therapist, works on two levels. First, it teaches you to recognize and change false beliefs that affect your ability to sleep — the idea that you need exactly eight hours of sleep every night, for instance, or that one restless night will make you sick. CBT also deals with misperceptions about the amount of time you actually spend sleeping. People with insomnia often sleep more than they realize. In therapy, you learn how much sleep you really need and how to plan for it.

The second part of CBT insomnia treatment deals with behavior, or what sleep experts call "sleep hygiene." This helps reprogram the part of the brain that governs the sleep-wake cycle. In CBT you learn to:

*Get up at approximately the same time every day, even on holidays and weekends.
*Get as much natural light as possible during the day, and limit light when you want to sleep.
*Go to bed only when you think you can fall asleep. If you haven't dozed off within 20 to 30 minutes, get out of bed and do something else until you feel drowsy. Limiting the amount of time you spend in bed when you're not actually sleeping increases your desire to sleep.
*Avoid napping during the day.
*Avoid caffeine, nicotine and alcohol, especially late in the day.
*Get regular exercise. Whether exercise close to bedtime disturbs sleep remains unclear and may vary from person to person.
*Start winding down an hour or two before bedtime. Turn down the lights. Stop watching television and using the computer. Take a warm bath.

Finding help
CBT for treatment of insomnia isn't available everywhere, and you may have to do some searching to find a trained practitioner. You can obtain a list of sleep centers, many of which are associated with major hospitals, from the National Sleep Foundation Web site. If you can't find a center near you, you may be able to locate a therapist who offers phone consultations. CBT books and tapes also are available. Once you've been through the program, you can usually solve future sleep problems yourself. And that's what makes CBT such a valuable insomnia treatment. It's a safe, highly effective and can be lasting solution for sleep problems.

Hope this helps!
From the mayo clinic web site.

Shalom!

[2stop]

I am a huge fan of CBT....and I never thought about using it for insomnia!
Thanks for posting this Teach.

They say this fibromyalgia crap is a lot related to a sleep disorder(or SOME believe this) there are all sorts of opinions about causes of fibromyalgia.

I am going to look into this.