Psychotherapy for Insomnia and Sleep Problems
Dr. Randi Fredricks, Ph.D.
When you’re desperate for sleep, it can be tempting to reach for a sleeping pill or an over-the-counter sleep aid. But sleep medication won’t cure the problem or address the underlying symptoms—in fact, it can often make sleep problems worse in the long term. That’s not to say there’s never a time or a place for sleep medication. To avoid dependence and tolerance, though, sleeping pills are most effective when used sparingly for short-term situations—such as traveling across time zones or recovering from a medical procedure. Even if your sleep disorder requires the use of prescription medication, experts recommend combining a drug regimen with therapy and healthy lifestyle changes.
Insomnia is a sleep disorder that is characterized by difficulty falling and/or staying asleep. People with insomnia have one or more of the following symptoms: Difficulty falling asleep. Waking up often during the night and having trouble going back to sleep.
Insomnia can be caused by psychiatric and medical conditions, unhealthy sleep habits, specific substances, and/or certain biological factors. Recently, researchers have begun to think about insomnia as a problem of your brain being unable to stop being awake (your brain has a sleep cycle and a wake cycle—when one is turned on the other is turned off—insomnia can be a problem with either part of this cycle: too much wake drive or too little sleep drive). It’s important to first understand what could be causing your sleep difficulties.
According to most therapists, behavioral and psychological counseling are recommended for people with poor sleep habits. Recognition that psychological and behavioral factors play an important role in insomnia and sleep problems has led to the increased use of psychotherapy in helping sleep disorders.
A study at Loughborough University in the U.K. noted that psychological treatment for insomnia improved sleep quality, reduced hypnotic drug use, and improved health-related quality of life for long-term medication users with chronic sleep difficulties.
Other research has shown psychotherapy to be superior to prescription sleeping medication. In a study at Harvard Medical School, researchers said the widespread use of psychotherapy by therapists could improve the quality of life of a large numbers of patients with insomnia.
Psychotherapy and Sleep Disorders
Research has indicated that psychotherapy from a qualified therapist can provide lasting change for people with sleep disorders. One study found that psychotherapy provided clinically significant sleep improvements within 6 weeks and that the improvements lasted through 6 months of follow-ups.
A number of studies on insomnia and psychotherapy have used cognitive behavioral therapy (CBT) as an effective method for treating sleep disorders. One study found that CBT actually helped to change people’s fundamental beliefs about sleep habits, concluding CBT is effective for reducing dysfunctional beliefs about sleep and such changes are associated with other positive outcomes in insomnia treatment. These findings highlight the importance of targeting sleep-related beliefs and attitudes in psychotherapy.
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Xu M, Belanger L, Ivers H, et al. Comparison of subjective and objective sleep quality in menopausal and non-menopausal women with insomnia. Sleep Med. 2011;12(1):65–9.
About the Author
Randi Fredricks, Ph.D. is a practicing therapist, researcher and author specializing in the treatment of anxiety, depression, addiction, eating disorders, and related disorders. Dr. Fredricks is a best-selling author of several books including Healing & Wholeness: Complementary and Alternative Therapies for Mental Health a 650-page compendium and landmark publication that provides a comprehensive overview of complementary and alternative treatments for mental health. For more information on Dr. Fredricks work, visit her practice website www.DrRandiFredricks.com.