Originally posted May 2, 2017.
Can insomnia be treated without medication?
Are you having trouble sleeping? Are you so tired that it’s interfering with your work? With your life? Are you feeling anxious and depressed and it seems linked to your lack of sleep?
Has your insomnia taken on a life of its own?
Do you worry about getting to sleep? Have you gradually become nervous about going to bed because a good, sound sleep eludes you?
Are your sleep medications no longer working for you?
Has t his been going on for you at least 3 time a week for at least three months? Do yo have trouble falling sleep, do you wake in the middle of the night or do yo have early morning awakenings?
Have you been to a Sleep Center and found that you do not have sleep apnea yet you still have insomnia?
And how about that depression? Is it the result of lack of sleep? Studies show that insomnia often predates a diagnosis of depression.
Are you interested in a natural treatment for insomnia?
If this sounds like you, Cognitive Behavioral Therapy for Insomnia (CBT-I), a short term, natural treatment method for insomnia, might be for you.
Cognitive Behavioral Therapy for Insomnia (CBT-I) is a relatively new, short term, solution-focused therapy designed to treat insomnia.
CBT-I can be safe to use in person who suffer from depression, anxiety, panic, PTSD, chronic pain and chronic illness. Plus, there is evidence that treating depression and insomnia together produces better results than just treating depression.
The CBT-I protocol arose from the past two decades of sleep research.
CBT-I has been proven via research to be an effective treatment for chronic insomnia.
Endorsed by all Major Medical Groups
CBT-I is endorsed as the first-line intervention for primary insomnia by the American Academy of Sleep Medicine as the first line treatment of primary insomnia. Primary insomnia is insomnia that is not due to a pre-existing medical condition.
The AASM Numerous endorses CBT-I as the first line of treatment for insomnia because numerous studies have shown that CBT-I is as effective in the short term as sedative hypnotics and more effective than sedative hypnotics in treating insomnia over the long term. The National Institutes of Health and the AASM endorse CBT-I as it has no long term side effects.
The main side effect is daytime sleepiness over a short period to time that might be concerning in some individualized situations, such as with a person who drives for a living.
Two Decades of Research
One such study, Cognitive-Behavior Therapy and Psychotherapy for Insomnia, was conducted by Gregg D. Jacobs, Ph.D. and his colleagues at Beth Israel Deaconess Medical Center (BIDMC) an Harvard Medical School. The study found that CBT-I is more effective than zolpidem, also known by the brand name Ambien, in treating chronic insomnia and maintaining therapeutic gains in proper sleep habits. By the middle of the CBT-I treatment plan, patients who weaned off their medication and were practicing the sleep protocols of the CBT-I treatment, were showing the most gains in sleep onset and efficiency.
What’s the Catch?
However, CBT-I requires you to really dig in and decide you want to do it, then become educated about sleep and then are willing to put with the temporary discomfort of restricting your sleep for a few weeks, and really following through and working with your clinician by following the treatment plan.
The CBT-I treatment plan takes place over about 6 – 8 sessions over about 3 months time.
The CBT-I treatment plan is highly individualized. We look at how your insomnia began. Often, insomnia can be trace to an upsetting life event, such as an illness, a death in the family or divorce. And then things just get perpetuated by behavioral and emotional factors. So we look at your life events, we looks at the cycles of sleep, sleep hygiene modifications, behavioral strategies (ie, stimulus control & sleep restriction), cognitive therapy, and relaxation practices. All of these components working together have been found to be the most effective approach in treating insomnia.
We’ll explore your thoughts and feeling around sleep and wakefulness, which may have inadvertently become habitual over time. My approach to sleep modification is to assist you to mindfully modify your thoughts, feelings and and behaviors around sleep, in a respectful and individualized manner. You can also choose complementary therapies to help you stick to the rigorous CBT-I treatment plan. With your hard work and support, you’ll be sleeping like a dog in no time!
I’ve studied CBT-I with Michael L. Perlis, Ph.D, Donn Posner, Ph.D. and Jason Ellis, Ph.D. at the Behavioral Sleep Medicine Program at the University of Pennsylvania and with Gregg D. Jacobs, Ph.D, of the Sleep Disorders Center at the University of Massachusetts Medical Center.