Sleep Therapy for Insomnia
Do you find yourself lying awake at night, unable to close your eyes and get the rest your body and mind need to meet the dawn? Do you worry about things you cannot change at midnight?
Defining insomnia:
Insomnia is a sleep-wake disorder characterized by sleep that is disrupted, too short or non-restorative. If you have insomnia, you may have difficulty falling asleep, you may find that you have problems remaining asleep, and/or you may sleep through the night but wake unrefreshed. In all of these scenarios, you find your sleep is insufficient, and that your poor sleep is eroding the quality of your day-to-day life.
Insomnia differs from occasional sleep disruptions:
We all have an occasional bad night’s sleep. Focusing on a conflict at home or a challenge at work, or ruminating at night about the list of things that need doing the next day can easily get in the way of our rest. A busy life can make turning off our minds at the end of the day a little difficult sometimes for us all.
But a diagnosis of insomnia means that you find yourself in this state at least three nights a week for a period of at least a month. How common is insomnia? CDC statistics indicate that approximately 4% of adults over the age of 20 receive a prescription sleep aid from their physicians every month. Even more people complain of chronically poor or disrupted sleep. Epidemiologists find that about 6% of the general population meet diagnostic criteria for insomnia. Women are more frequently diagnosed with this disorder than are men. Chronically disrupted sleep is common, indeed.
Some of the consequences of insomnia:
If you are suffering from insomnia you probably feel foggy, crabby and not yourself. Your thinking may be somewhat slowed, and you are at greater risk for making errors. Your reaction time is likely also slower, making things like driving more dangerous than usual. Insomnia also causes or contributes to a number of medical and mental health conditions. If insomnia is a problem for you, there is help available in the form of sleep therapy. Together your physician and sleep therapist can work with you to develop an insomnia treatment focused on helping you return to restorative sleep.
Causes of insomnia, and teasing out why someone has it:
Insomnia can be triggered by many things—a medical illness, stress, mental health challenges or physical pain to name a few. Insomnia is a risk factor for some mental health disorders and a symptom of others. Because of this, it is important to review your disrupted sleep with a sleep therapist. Since a change in sleep patterns can also be a symptom of a number of medical conditions, when we begin to work on sleep therapy together, we will do so in consultation with your primary care doctor in order to rule out those illnesses.
What a sleep therapist does:
When I work with you as your sleep therapist, we will create a safe and supportive relationship that gives you freedom to explore your sleep symptoms and what they may say about your life challenges. As your sleep therapist I will also problem solve with you to clarify the things you may be doing and the thoughts you may be having that contribute to your sleep problems. Once your physician has given you a clean bill of health or has set a plan in place to address the medical issues related to your disrupted sleep, together we will establish a sleep therapy plan tailored for you, using established sleep therapy principles.
How our sleep therapy will work:
Sleep therapy provided by a knowledgeable sleep therapist is a well-established cognitive behavioral intervention. My sleep therapist tools will help you focus on your specific habits, behaviors, thoughts and beliefs that affect your sleep.
Together we will create a collaborative, warm and supportive environment focused on helping you manage those factors that get in the way of your sleep. In our sleep therapy work together you will learn to manage and address behaviors and lifestyle habits including
Developing a specific nighttime schedule
How to manage if you find yourself in bed and unable to sleep
What to do about screen time at night
We will also focus on specific cognitive behavioral interventions to address negative learned behaviors and ways of thinking that perpetuate lack of sleep, with the aim of
Helping you recognize unhelpful patterns of thought around sleep
Helping you develop alternative patterns of thinking that will be compatible with sleep
Helping you develop relaxation skills so that you can learn to calm your body and mind
With time and a collaborative approach to your care, my sleep therapist interventions can help you return to restorative sleep patterns.
What is the role of medications in treating insomnia?
Sleep medication alone is not indicated in the treatment of insomnia, as it will not help you learn new skills to address sleep problems and better manage healthy sleep patterns. Research suggests that the short-term use of medication, when combined with sleep therapy may be helpful for some patients. Talk therapy alone, when undertaken with a sleep therapist, is a useful tool in treating insomnia.
Are there treatments that are proven to be more effective for insomnia?
According to Schutte-Rodin, Broch, Byusse, Dorsey and Sateia (2008), “initial approaches to treatment should include medical evaluation and at least one behavioral intervention such as stimulus control therapy or relaxation therapy, or the combination of cognitive therapy, stimulus control therapy, sleep restriction therapy with or without relaxation therapy—otherwise known as cognitive behavioral therapy for insomnia (CBT-I). Multicomponent therapy (without cognitive therapy) is effective and recommended therapy in the treatment of chronic insomnia. Other common therapies include sleep restriction, paradoxical intention, and biofeedback therapy. Although all patients with chronic insomnia should adhere to rules of good sleep hygiene, there is insufficient evidence to indicate that sleep hygiene alone is effective in the treatment of chronic insomnia. It should be used in combination with other therapies. When an initial psychological/ behavioral treatment has been ineffective, other psychological/ behavioral therapies, combination CBT-I therapies, combined treatments (see below), or occult comorbid disorders may next be considered” (2008, p. 488).
If I have insomnia, is it always going to be a problem for me?
Individuals who have difficulty with insomnia do find they tend to relapse during times of stress. Good follow-up, sometimes including six-month checkups with your physician and/or sleep therapist can help you monitor your progress in this regard.
I would be glad to discuss insomnia treatment with you. Feel free to call me.
Schutte-Rodin, S., Broch, L., Byusse, D., Dorsey, C., and Sateia, M. (2008). Clinical guideline for the evaluation and management of chronic insomnia in adults. Journal of Clinical Sleep Medicine, 4 (5), 487-504.
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