2023-08-30 18:00:42
Approximately one in four adults in the United States develop symptoms of insomnia each year. In most cases, these are temporary and are caused by things like stress or illness, but it is estimated that one in ten adults have chronic insomnia, which is defined as difficulty falling asleep or staying asleep. at least three times a week for three months or more.
Sleep deprivation not only causes physical health problems, but it can also affect the mind. For example, a recent survey by the National Sleep Foundation revealed a link between poor sleep health and symptoms of depression. In addition, there are studies that show that lack of sleep can cause healthy people to experience distress and anxiety. Fortunately, there is a well-studied and proven treatment for insomnia that almost always works in eight sessions or less: Cognitive Behavioral Therapy for Insomnia (CBT-I).
If a CBT-I specialist cannot be found, instructions for CBT-I are easy to access online. However, it’s rarely the first thing people try, said Aric Prather, a sleep researcher at the University of California, San Francisco, who treats patients with insomnia.
Rather, people almost always turn to drugs. According to a 2020 survey from the Centers for Disease Control and Prevention, more than eight percent of adults reported taking sleep aids every day or most of them to fall asleep or stay asleep.
Some studies have shown that CBT-I is as effective as using sleeping pills in the short term, and more effective in the long term. Data from clinical trials indicates that up to 80 percent of people who try CBT-I see improvement in their sleep, and most patients find relief within eight sessions, or four, even when they have suffered from insomnia for decades, said Philip Gehrman, director of the Laboratory of Sleep, Neurobiology and Psychopathology at the University of Pennsylvania.
Sleeping pills can carry some risks, especially for older adults, who may have some setbacks such as falls, memory problems, or confusion as a result of using the medication. On the other hand, CBT-I is considered safe for adults of any age; It can even be adapted for use on children.
What is CBT-I?
Many people mistakenly assume that CBT-I focuses entirely on sleep hygiene — the proper routines and environment for good sleep, said Shelby Harris, a psychologist in private practice in the area of New York City and specializes in CBT-I.
It is true that CBT-I uses a series of treatments to counteract sleep-inhibiting behaviors, such as napping during the day or using digital devices before going to sleep, and replaces them with more effective ones, such as always wake up at the same time, but it also addresses anxiety and negative beliefs about sleep.
Much of the time, insomnia can lead to the feeling that sleep has become “unpredictable and discontinuous,” Prather said. “Patients with chronic insomnia think every day: ‘How will I sleep tonight?’”
CBT-I teaches patients various ways to relax, such as deep breathing and mindfulness meditation, and helps them set realistic expectations about their sleep habits.
It’s especially important that people with insomnia learn to see their bed as a place for restful sleep and not associate it with tossing and turning. Patients undergoing this treatment are asked, if they do not sleep after 20 to 30 minutes, to get out of bed and do some quiet, dimly lit activity that does not involve electronics. Also, they are told to stay in bed only when they are drowsy or sleeping.
“CBT-I makes sleep more consolidated and takes less time for the patient to fall asleep, which is a big win for a lot of people,” Harris explained.
How do we find someone who offers this therapy?
Experts advise that if you’re having trouble sleeping, you should first see your GP to rule out any physical (such as thyroid imbalance, chronic pain, or sleep apnea) or psychological (such as depression) problems, which may require a different treatment.
You can search for a specialist who is a member of the Society for Behavioral Sleep Medicine or use Penn International’s Directory of CBT-I Practitioners. Maybe your GP can give you some advice. If you turn to an online general directory of therapists, such as Psychology Today, be wary of those who claim to offer insomnia treatments but don’t have specific training in CBT-I, Harris warned.
Because there are fewer than 700 trained behavioral sleep medicine professionals in the United States, it may be hard to find someone who specializes in CBT-I (especially someone who works with health insurance). Furthermore, a 2016 study revealed that these are unevenly distributed: 58 percent of them work in twelve states. The clinic where Prather works, for example, has a waiting list of hundreds of people.
A woman lies on a bed in New York on June 9, 2023. (Tonje Thilesen/The New York Times)
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