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Got Insomnia? Try Cognitive Behavioral Therapy

September 26, 2016
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Do you have a hard time staying asleep at night? You’re not alone. According to the Centers of Disease Control and Prevention (CDC), Americans are not getting enough sleep. Over a third of the nation is sleeping less than seven hours on a regular basis, and ten percent of the population has chronic insomnia. The CDC also warns that a lack of sleep can put you at risk for high blood pressure, diabetes, stroke and heart disease. So what do scientists recommend for a long, uninterrupted night? Cognitive behavioral therapy for insomnia (C.B.T.-I) may be the answer. C.B.T.-I challenges the way you look at sleep by focusing on positive thinking and a uniform bedtime routine. A typical program recommends:
  • Getting in and out of bed everyday at the same time.
  • Not sleeping in. Those extra four hours in bed on the weekend can mess with your body’s sleep rhythm.
  • Using a sleep log. This helps clinicians catch bad habits hindering your sleep.
  • Thinking positively. Negative thoughts in bed can become their own self-fulfilling prophecies.
The problem with C.B.T.-I is that it’s so new, it lacks experts in the field. “The number of clinicians nationally who know how to do C.B.T. for insomnia is a couple thousand. We need 100,000,” said Dr. Gregg Jacobs, assistant professor and sleep medicine specialist at the University of Massachusetts Medical School, “There are tens of millions of people out there who have insomnia.” Since there are few physicians available in-person for C.B.T.-I, experts recommend patients go online. A study by the Aarhus University in Denmark found that there were no dramatic differences between face-to-face C.B.T.-I and online therapy. Individuals who used online C.B.T.-I improved insomnia severity, sleep quality and total sleep time. The average user also gained an extra 20 minutes of quality sleep at night. “Personally, I’m glad I got started with an online program,” said Roni Rabin, a Wellness writer for the New York Times, “I have a pretty busy schedule, so it would be tricky squeezing in a weekly appointment with a therapist.” Online C.B.T.-I does have its skeptics. Some health professionals believe that insomnia cannot be approached with a “cookie-cutter” process, as each case is unique. “One concern is that some insomniacs may have another psychiatric disorder that needs to be addressed, like depression or anxiety, or an undiagnosed sleep disorder like sleep apnea,” said Jennifer L. Martin, associate professor at the University of California, Los Angeles’ School of Medicine. Insomnia can be caused by unhealthy sleep patterns, biological factors or psychiatric conditions. Researchers believe that an insomniac’s brain can’t go to sleep because it is stuck on its wake cycle. Short-term fixes include avoiding heavy meals before bed, leaving work at the office and turning off technology at night. If you still cannot sleep after a couple weeks, it may be chronic insomnia. If you are interested in an online sleep program, Rabin used “Conquering Insomnia,” a $40, five week C.B.T.-I course. Rabin also recommends SHUTi, which charges $135 for a 16-week session. Both online programs offer individualized feedback on sleep logs.
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