Tuesday, 3 May 2016

The Clinical Definition Of Insomnia Hasn’t Changed — But The Treatment Has

The Clinical Definition Of Insomnia Hasn’t Changed — But The Treatment Has


The best treatment for insomnia, according to the American College of Physicians.
Cognitive behavioral therapy for insomnia is the best treatment for people suffering from chronic insomnia, advises the American College of Physicians (ACP).

The ACP has published new practise guidelines on insomnia.

As many as 1 in 10 people experience chronic insomnia.

Chronic insomnia is usually defined as having disturbed sleep on at least three nights per week over three months.

Women are more likely to suffer than men and it can lead to all sorts of debilitating effects including difficulties with mood, memory, attention and risky behaviours (read on: Lack of Sleep: The 10 Most Profound Psychological Effects).

Cognitive behavioral therapy, or CBT-I. involves learning the correct sleep habits as well as addressing thoughts about sleep.

Here is one of the techniques that is taught:

Dr Wayne J. Riley, ACP President, said.

“Cognitive behavioral therapy for insomnia is an effective treatment and can be initiated in a primary care setting.

Although we have insufficient evidence to directly compare CBT-I and drug treatment, CBT-I is likely to have fewer harms.

Sleep medications can be associated with serious adverse effects.”

People can receive CBT-I face-to-face, in group, over the phone or even online.

If CBT-I doesn’t work then it may be appropriate to add drugs.

Dr Riley said:

“Medications should ideally be used for no longer than four to five weeks while the skills learned in CBT-I can manage insomnia over the longer term.

Before continuing drug therapy, doctors should consider treatable secondary causes of insomnia such as depression, pain, enlarged prostate, substance abuse disorders, and other sleep disorders like sleep apnea and restless legs syndrome.”

One study has even found that insomnia can be cured in a single one-hour session:

The new guidelines were published in the journal Annals of Internal Medicine (Qaseem et al., 2016).

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