Behavioral interventions for insomnia include relaxation training, stimulus control therapy, sleep restriction therapy, sleep hygiene, paradoxical intention therapy, cognitive restructuring, and other approaches. These are briefly explained.
Full Answer
What are behavioral interventions for insomnia?
This article presents an overview of behavioral interventions for insomnia. Behavioral interventions for insomnia include relaxation training, stimulus control therapy, sleep restriction therapy, sleep hygiene, paradoxical intention therapy, cognitive restructuring, and other approaches.
What is the best non medical treatment for insomnia?
Non-Medical (Cognitive & Behavioral) Treatments for Insomnia. Cognitive behavioral therapy (CBT) includes behavioral changes (such as keeping a regular bedtime and wake up time, getting out of bed after being awake for 20 minutes or so, and eliminating afternoon naps) but it adds a cognitive or "thinking" component.
What are the different types of cognitive therapy for insomnia?
There are several forms of cognitive therapy for insomnia. These can involve didactic focus, paradoxical intention, distraction and imagery techniques, and cognitive restructuring. There is an attempt to alter dysfunctional attitudes and beliefs about sleep, the consequences of which can be insomnia.
What is relaxation therapy for insomnia?
Relaxation therapy is based on observations that insomnia patients often display high levels of physiologic, cognitive, and/or emotional arousal, both at night and during the daytime.[23]
What are the two types of treatment for insomnia?
Two types of treatment for insomnia have received adequate empirical support: hypnotic medications and cognitive behavioral interventions.
What is insomnia treatment?
Insomnia is a general clinical term that refers to a difficulty in initiating or maintaining sleep. Insomnia is widely prevalent in the general population, especially in the elderly and in those with medical and psychiatric disorders. Hypnotic drug treatments of insomnia are effective but are associated with potential disadvantages. This article presents an overview of behavioral interventions for insomnia. Behavioral interventions for insomnia include relaxation training, stimulus control therapy, sleep restriction therapy, sleep hygiene, paradoxical intention therapy, cognitive restructuring, and other approaches. These are briefly explained. Research indicates that behavioral interventions are efficacious, effective, and likely cost-effective treatments for insomnia that yield reliable, robust, and long-term benefits in adults of all ages. Detailed guidance is provided for the practical management of patients with insomnia.
What are the treatments for insomnia?
Early psychological treatments for insomnia focused on primary insomnia. Application of behavioral therapeutic approaches in the treatment of insomnia began with interventions such as systematic desensitization,[12] relaxation,[13] hypnosis,[14] biofeedback,[15] and paradoxical intention[16] which targeted hyperarousal associated with insomnia. During the 1970s, stimulus control therapy for insomnia was introduced.[17] In the late 1980s, a new behavioral intervention, sleep restriction, was introduced.[18] Around the same time, the application of cognitive restructuring for dysfunctional beliefs related to insomnia was proposed[19] and subsequently formalized and integrated into several multi-component treatments of insomnia.[20]
What is relaxation therapy?
Relaxation therapy is based on observations that insomnia patients often display high levels of physiologic, cognitive, and/or emotional arousal, both at night and during the daytime.[23] A number of formal relaxation therapies have been applied to insomnia since such therapies reduce the sleep-related performance anxiety and bedtime arousal common to this condition.[24–27] This type of intervention may be most suitable for patients who characterize their insomnia as an “inability to relax” and/or for patients who present with multiple somatic complaints. Progressive muscle relaxation (PMR), autogenic training, and biofeedback are aimed at reducing somatic arousal (e.g., muscle tension). Biofeedback is a form of relaxation that provides sensory feedback (visual or auditory, either mechanically or with computers and amplifiers) to help patients learn how to control physiological parameters such as galvanic skin response or muscle tension in order to reduce somatic arousal.
What is insomnia in a psychiatric setting?
It may present as an independent problem (primary insomnia) or as part of a coexisting medical or psychiatric condition (secondary insomnia). According to ICD-10,[1] nonorganic insomnia (F 51.0) is defined as a problem in initiating and/or maintaining sleep or the complaint of nonrestorative sleep that occurs on at least three nights a week for at least a month, and is associated with daytime distress or impairment. The diagnosis primary insomnia (307.42) in DSM-IV[2] is used to distinguish insomnia that is considered to be a distinct diagnostic entity from insomnia that is a symptom of an underlying medical and/or psychiatric condition. The DSM lists insomnia related to other Axis I or Axis II disorders as distinct from primary insomnia.
How does sleep restriction work?
Spielman et al.[18] developed sleep restriction therapy for insomnia based on this biological drive. It is a behavioral technique which is essentially a systematic, controlled, partial form of sleep deprivation designed to consolidate sleep rapidly and then gradually increase the scheduled time allotted for sleep when adequate sleep efficiency has been achieved. The goal of sleep restriction is to regulate the sleep-wake cycle by tailoring the time spent in bed to the patient's true sleep need. [18] It begins by calculating average total sleep time, which is accomplished by completing sleep logs that record the duration of time in bed and the total duration of time spent sleeping. If a person with insomnia stays in bed for 9 h per night but is only sleeping for 6 h per night, he is advised to limit the time in bed to 6 h, which is his “sleep window.” Therapy seeks to consolidate sleep such that time passed in bed is spent sleeping rather than awake. The sleep efficacy ([total sleep time/total in bed] × 100) goal for a person with insomnia should be around 85%.
How prevalent is insomnia?
Insomnia is widely prevalent and is reported to occur in up to one-third of the adult population.[5] Persistent sleep problems have been reported by 10-15% of adults.[6,7] The prevalence of sleep problems among women and older adults is even higher.[8,9] Although more than half of primary care patients may experience insomnia, only about one-third report this problem to their physicians[10] and only 5% seek treatment.[6] Despite the very high economic cost of insomnia in terms of lost productivity and accidents,[11] the vast majority of persons with insomnia remain untreated.[7] Two-thirds of patients with insomnia report a poor understanding of treatment options, and many turn to alcohol (28%) or untested over-the-counter remedies (23%).[6]
How to treat insomnia 4?
Treating chronic insomnia 4 includes two main objectives: improving sleep quality and duration, and reducing associated daytime impairments. A chronic insomnia treatment regimen typically includes at least one behavioral intervention, which often takes the form of cognitive behavioral therapy for insomnia (CBT-i); if therapy and other behavioral interventions are not effective, your doctor may recommend some form of sleep medication.
What is insomnia diagnosis?
Lack of motivation or energy. An insomnia diagnosis will include a standard medical exam and questionnaire. These procedures allow your doctor to determine whether the insomnia is an isolated condition, or if you’re experiencing insomnia symptoms due to an underlying disease or medical disorder.
How does biofeedback 7 help with insomnia?
Biofeedback 7 – which helps you control different bodily functions based on your blood pressure, breathing and heart rates, and other metrics – can also be effective for reducing insomnia symptoms and improving sleep . The number of qualified behavioral sleep medicine therapists in the U.S. is fairly limited.
What is sleep hygiene?
Specifically, sleep hygiene focuses on increasing behaviors that improve sleep quality and quantity while eliminating behaviors that cause sleep problems.
What is chronic insomnia?
Chronic Insomnia Treatment. Insomnia is a disorder characterized by persistent difficulty 1 with sleep onset, maintenance, consolidation, or quality. People who have insomnia struggle with sleep despite adequate opportunities for sleep, and also experience excessive daytime sleepiness and other dysfunctions when they are awake.
What is a BZD?
Benzodiazepines: Known as BZD for short, benzodiazepines are a class of psychoactive drugs. A total of five BZDs have been approved for treating insomnia by the U.S. Food and Drug Administration, including those with short-, intermediate-, and long-acting effects.
How long does insomnia last?
These symptoms must occur for at least 3 months despite adequate opportunities for sleep on a nightly basis.