Cognitive behavioural therapy is an effective treatment for insomnia

For the last 3 years, I’ve been working with a team led by Dr James Trauer who have pulled together all the research on cognitive behavioural therapy for insomnia (CBTi) and analysed the results.

The research showed that on average people went to sleep 19 minutes faster and stayed asleep 26 minutes longer after CBTi. This is similar to the effects of sleeping tablets, but without the negative effects and the effects persisted long after treatment finished.

This research was published in the Annals of Internal Medicine on June 9th 2015, and was covered by a number of media outlets who also wrote commentaries on the role of non-drug treatment such as CBTi in treating insomnia. Some of the media stories are at the following links:

Annals of Internal Medicine also put together a short video on cognitive behavioural therapy for insomnia and the findings of the research that you can find here.

What is cognitive behavioural therapy?

There are 5 core components to cognitive behavioural therapy for insomnia (CBTi). They are:

  1. Stimulus control – basic principle is getting out of bed if you wake during the night and doing something else until you feel sleepy again
  2. Sleep restriction – this involves matching the time you spend in bed more closely to how much sleep you are actually getting
  3. Relaxation training – developing confidence in relaxation strategies that you can use if you wake at night and feel anxious, and can also use to manage stress and anxiety through the day are an important part of sleeping well
  4. Cognitive therapy – involves challenging beliefs about sleep that people with insomnia tend to develop over time, like believing that unless sleep meets certain parameters they won’t be able to function the next day.
  5. Sleep hygiene – consists of ensuring that body and mind are ready for sleep on getting in to bed and you have an appropriate sleeping environment without too much light or noise.

In general, CBTi is a treatment that takes between 4-6 sessions working with a psychologist experienced in treating sleep disorders and insomnia. In our research, the shortest treatment was 2 sessions and the longest 8 sessions.

What research is currently going on in CBTi?

Current research in the area of CBTi is along the lines of how we can further improve CBTi to get even better results. One of the techniques that can be added to CBTi is the use of mindfulness-based therapy. We have also completed research on a treatment that combined mindfulness with CBTi, showing it added to the effects of CBTi and hope to publish the research in the next year.

There is also research going on looking at how CBTi can be made more accessible using online programs or developing treatment programs that don’t need the expertise of psychologists or doctors who specialise in managing insomnia and sleep disorders. Two examples of online CBTi programs with good research showing they are effective are:

  • Sleepio – UK-based online program developed with Prof Colin Espie
  • Shuti – US-based program developed by University of Virginia with Prof Charles Morin

Where can I access CBTi in Australia?

Related posts & links:

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