to explain purpose of cognitive behavioral therapy for insomniaDo you or someone you care about suffer from sleepless nights?  Do you find difficult to fall asleep or stay asleep?  Do you wake up in the morning feeling tired?  Is your lack of sleep starting to make you feel depressed or anxious?  You are not alone!  Nearly one-third of Americans are sleep deprived according to the Centers for Disease Control (Center for Disease Control, 2016).  Yet, there is hope!

CBTI stands for Cognitive Behavioral Therapy for Insomnia. In short, CBTI is a non-pharmacological evidence-based treatment utilized to treat insomnia. Similar to other cognitive behavioral therapy strategies, CBTI addresses the behaviors and internal belief systems that obstruct healthy sleep patterns.  By strengthening the homeostasis sleep drive, that is the innate drive that prompts the sleep process, CBTI is a proven strategy to help those struggling with insomnia. Under a trained clinician or physician utilizing CBTI, many patients have improved sleep patterns, quality of sleep, and improved lifestyles.  It is also important to note that sleep difficulty can be the result of other sleep disorders.  Therefore, it is recommended you seek out the advice of a physician to be evaluated for proper diagnosis and treatment.

Here are 7 reasons you should consider Cognitive Behavioral Therapy for Insomnia (CBTI):

1. CBTI is the initial treatment recommended for insomnia

Many options come to mind when considering the traditional recommendations of how to treat insomnia, including sleep hygiene and medication.   In 2016,  The American College of Physicians recommended “…CBT-I as the first line of treatment for adults with chronic insomnia.”   The ACP stated the adverse side effects, costs, and short duration of how long traditional sleep medicine should be prescribed as the reasoning behind their preference CBTI for the standard treatment for insomnia.

2.  Cognitive Behavioral Therapy for Insomnia is just as effective and potentially more durable than medication

Medication management has long been used as a sole treatment for insomnia.  While in the immediate it can seem beneficial, the results can be short-lived and may cause more significant problems.  Besides the potential side-effects, increased tolerance, and possible addictive tendencies,  medication often is not a permanent resolution for those struggling with the issue of insomnia (Mitchell, Gherman, Perlis and Umscheid  2012).  Studies continue to affirm the effectiveness of CBTI with patients falling asleep faster and staying asleep longer and experiencing fewer episodes of waking up in the middle of the night.  Additionally, patients with CBTI continue to have improved sleep patterns for more extended periods after the initial treatment time has ended.   Hence, some researchers have concluded, “The effects of CBT-I appear to be sustained over time, while the effects of drug therapy decline. (Mitchell, Gherman, Perlis & Umscheid 2012).  

3. Natural and medication-free

CBTI does not require any medication or supplements to be effective. While it can complement medications and supplements, CBTI is a stand-alone treatment that results in more significant restorative sleep.  As such, patients as young as preschool and mature as the elderly can receive this therapy with the optimal potential for improved sleep.

4.  Reduce and possibly treat depression  

Chronic insomnia can intensify depressive feelings and possibly create them.  Sleep is intended to be a time of rejuvenation, both physically and emotionally.  Long periods of not sleeping well will leave anyone feeling depressed and melancholy.  Because of the reciprocal relationship between sleep and depression, researchers have actually started to consider using cognitive behavioral therapy for insomnia as a non-pharmacological treatment with patients that have been diagnosed as clinically depressed. (Gee, Orchard, Clarke, Joy, Clarke & Reynolds 2018).

5.  Treat sleep anxiety

Sleep anxiety occurs when someone experiences anxiety related to sleep.  For example, the stress may manifest itself by being worried that you will not sleep tonight or that this chronic insomnia will never end.  Another example may be that the continued sleep deprivation will lead to poor performance at work and getting dismissed, or constantly worrying about the harmful effects of poor sleep on your long term health. CBTI alleviates sleep anxiety by identifying any negative thinking patterns that can prevent consistent sleep and transforming into healthy ones.  By helping insomnia sufferers debunk the myths and misinformation, he/she can discover the reality of a better life because of sleeping better. 

6.  Improve physical health

Not getting enough sleep is not beneficial for optimum physical health.  Untreated insomnia can cause an increased risk for cardiovascular disease, hypertension, Type 2 diabetes, and possibly stroke.  There are things a person can do to address insomnia.  CBT-I improves any behavioral intervention that is counterproductive to restorative sleep by implementing good sleep hygiene, sleep efficiency schedules, and stimulus control.  Likewise, CBTI has been shown to assist with coping skills in patients that experience chronic pain (Jungquist, O’Brien, Matteson-Rusby, Smith, Pigeon, Xia, Lu and Perlis  2010).   Sleeping better often improves the quality of life for those that struggle with chronic pain. 

7.  Getting unstuck 

Chronic insomnia suffers may feel stuck in an endless cycle of poor sleep and lack of energy often wondering if they will ever be able to sleep well again.  CBTI can help provide a renewed empowerment by regaining control over what often feels like an uncontrollable condition.  

 

 

 

 

 

 

Center for Disease Control. (2016). 1 in 3 Adults Do Not Get Enough Sleep. Retrieved from https://www.cdc.gov/media/releases/2016/p0215-enough-sleep.html

American College of Physicians. (2016, May 3).  ACP Recommends Behavioral Therapy as Initial Treatment for Chronic Insomnia [Press Release]. Retrieved from https://www.acponline.org/acp-newsroom/acp-recommends-cognitive-behavioral-therapy-as-initial-treatment-for-chronic-insomniastencies regarding healthy sleep that further insomnia. 

Mitchell, M. D., Gehrman, P., Perlis, M., & Umscheid, C. A. (2012). Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review. BMC family practice, 13, 40. doi:10.1186/1471-2296-13-40. Retrieved from 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481424/

Gee, B, Orchard B.F., Clarke E., Joy, A, Clarke T., Reynolds, S. (2019).  The effect of non-pharmacological sleep interventions on depression symptoms: A meta-analysis of randomised controlled trials. Sleep Med Rev, 43, pp. 118-128.   Retrieved from https://www-sciencedirect-com.ezproxy.liberty.edu/science/article/pii/S1087079218302089#bib18

Bertisch, S. M., Pollock, B. D., Mittleman, M. A., Buysse, D. J., Bazzano, L. A., Gottlieb, D. J., & Redline, S. (2018). Insomnia with objective short sleep duration and risk of incident cardiovascular disease and all-cause mortality: Sleep heart health study. Sleep, 41(6) doi:http://dx.doi.org.ezproxy.liberty.edu/10.1093/sleep/zsy047

Shivashankar, R., Kondal, D., Ali, M. K., Gupta, R., Pradeepa, R., Mohan, V., . . . Peasey, A. (2017). Associations of sleep duration and disturbances with hypertension in metropolitan cities of delhi, chennai, and karachi in south asia: Cross-sectional analysis of the CARRS study. Sleep, 40(9) doi:http://dx.doi.org.ezproxy.liberty.edu/10.1093/sleep/zsx119

Insomnia may significantly increase stroke risk. (2014, April 27). NewsRx Health & Science, 100. Retrieved from https://link-galegroup-com.ezproxy.liberty.edu/apps/doc/A366970917/HWRC?u=vic_liberty&sid=HWRC&xid=27fea5fb

Lin, C‐L, Chien, W‐C, Chung, C‐H, Wu, F‐L. Risk of type 2 diabetes in patients with insomnia: A population‐based historical cohort study. Diabetes Metab Res Rev. 2018; 34:e2930. https://doi-org.ezproxy.liberty.edu/10.1002/dmrr.2930

Junquist , C.,  O’Brien, C., Matteson-Rusby, S., Smith, M. T., Pigeon, W.R., Yinglin, X., Naiji, L., Perlis, M.L. (2010, March).   The efficacy of cognitive-cognitive-behavioral therapy for insomnia in patients with chronic pain. Sleep Medicine, 11(3)  https://doi.org/10.1016/j.sleep.2009.05.018