Cognitive behavioral therapy might help patients with chronic insomnia fall asleep faster and stay asleep longer in as few as five sessions, according to research presented recently at the annual meeting of the Associated Professional Sleep Societies.
Ryan Wetzler, PsyD, Director of the Behavioral Sleep Medicine Clinic at Sleep Medicine Specialists in Louisville, Ky., and colleagues studied 115 patients who had undergone at least two therapy sessions in a clinical referral setting. All patients took 30 minutes or longer to fall asleep or had poor sleep maintenance after falling asleep.
Researchers analyzed diaries in which the patients' sleep patterns were recorded. After at least two therapy sessions, patients who had difficulty falling asleep reduced sleep onset by an average of 58 minutes, and those with nighttime wakefulness could return to sleep in about 30 minutes, both significant improvements.
Subjects with both symptoms (50 patients) cut an average of 40 minutes from the time they needed to fall asleep and could return to sleep about 41 minutes faster.
Subanalysis of 64 patients who completed at least five treatment sessions revealed significant improvements in sleep efficiency, average nightly awakenings, total sleep time, and the average number of nights patients used sleep medication.
“It's clear from studies like this that behavioral interventions are as effective as pharmacological treatments in the long-term treatment of insomnia,” said Donna Arand, PhD, clinical director of the Sleep Disorders Center at Kettering Hospital in Dayton, Ohio.
Dr. Wetzler said patients undergoing cognitive behavioral therapy for insomnia identify common causes and use diaphragmatic breathing and progressive muscle relaxation techniques to interrupt stress.
Dr. Arand noted the shortage of clinicians certified to conduct this therapy, but said increasing interest among psychologists and physicians would solve the problem.