Overcoming Insomnia: A Cognitive-Behavioral Therapy Approach, Therapist Guide

It is estimated that one in ten U.S. adults suffers from chronic insomnia. If left untreated, chronic insomnia reduces quality of life and increases risk for psychiatric and medical disease, especially depression and anxiety. There are two forms of insomnia: secondary insomnia, in which it is comorbid with another condition such as psychiatric disorders, chronic pain conditions, or cardiopulmonary disorders, and primary insomnia, which does not coexist with any other disorder, Though insomnia may be caused by any number of things, it is primarily sustained by the development of poor sleep habits (such as varying sleep-wake schedule, daytime napping, and spending excessive time in bed) as an attempt to manage the problem. This treatment program uses cognitive-behavioral therapy methods to correct those poor sleep habits. CBT has been proven in multiple studies to improve sleep hygiene by reducing time spent in bed before sleep onset, reducing time spent awake after first sleep onset, and increasing the quality and efficiency of sleep. Developed by the authors, this evidence based treatment can be used for both primary and secondary insomnia sufferers. Patients are first given information about healthy sleep and the reasons for improving sleep habits, then a behavioral program is developed to address that patient's specific sleep problems. Use of sleep logs, assessment forms, and other homework (all provided in the corresponding workbook) allows client and therapist to work together to develop an effective sleep regimen tailored specifically for each client. Finally, several sessions are dedicated to increasing compliance and problem-solving.