Cognitive behavioural therapy (CBT) can be a highly effective treatment for insomnia, particularly for adults over age 55, several studies show.
The American Academy of Sleep Medicine recommends CBT-I (CBT for insomnia) as a first-line treatment, due to its exemplary safety record over pharmaceuticals. CBT has few drawbacks and no side effects, except that it requires commitment.
As we age, we tend to suffer more insomnia than in our younger years. An estimated 20 to 40 per cent of older adults have insomnia. Unfortunately, medication is frequently the first treatment choice.
Pharmacotherapeutic agents are effective short term, but long-term safety and efficacy in aging adults are unknown. And clinical trials of insomnia medications rarely include geriatric patients.
CBT focuses on how our thoughts, beliefs and attitudes can affect our feelings and behaviour. CBT is not designed to be long-term: it is generally considered short-term therapy. Treatments require anywhere from four to 20 sessions, each about 30 to 60 minutes. The object of the treatments is to learn adaptive skills with quick, practical “mindful” exercises, then continue those exercises daily. Refresher sessions are an option for those who may revert to negative thought patterns, but CBT has proven to be effective long-term.
Along with identifying and replacing limiting, negative beliefs that may interfere with sleep, CBT-I intervention also includes a focus on several lifestyle and mental health components that are key to improved sleep:
- Structured sleep hours for bedtime and rising (napping is discouraged).
- Removing factors that can disrupt falling asleep (noise, lighting, room temperature, digital and electronic devices, etc.).
- Sleep hygiene for optimal sleep (nutrition and physical activity during the day, etc.).
- Relaxation training (meditation or breathing exercises, etc.).
There are some downsides to CBT-I. It requires commitment to be successful. It is more labour-intensive than medications and requires a trained and motivated provider. Session fees may also be a factor. However, CBT is a common, popular therapy, so you will likely find a practitioner in your area. Some may offer online sessions for those with mobility or transportation concerns.
Insomnia can create physical and emotional distress. For those uncomfortable taking over-the-counter treatments, knowing there are options other than medications is a relief. Talk to your physician and visit a CBT practitioner.
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Eve Lees has been active in the health & fitness industry since 1979. Currently, she is a Freelance Health Writer for several publication and speaks to business and private groups on various health topics.