Tuesday, June 2, 2015

Treating Insomnia

It’s good news for insomniacs. For psychotherapists it will count as a mixed blessing. It will be bad news for those who manufacture Ambien.

Jason Ellis, a psychologist from Northumbria, England has fashioned a simple and effective treatment for insomnia. It works best for those who have only recently started having trouble sleeping. The patients in the study were not taking medication to sleep.

The bad part is that Ellis’ treatment involves one session of cognitive therapy. You heard it right, one session of one hour.

As I said, many therapists will greet this news with a mix of elation and chagrin.

The Daily Mail reports on the research:

The participants were separated into two groups, each with nine males and eleven females.

They all used sleep diaries to record the quality and duration of their sleep for seven days before treatment.

They also completed the Insomnia Severity Index which measures the nature, severity and impact of insomnia.

One group received treatment of a one-hour one-to-one cognitive behavioural therapy session delivered by Professor Ellis, who is also director of the Northumbria Centre for Sleep Research.

They also received a self-help pamphlet to read at home, while the control group received no additional support.

Most interesting were the results:

After treatment there was a significant difference between the group that had received cognitive behavioural therapy and the control group.

Within one month of the therapy session, 60 per cent of participants reported improvements in their sleep quality. Within three months, this had increased to 73 per cent.

Meanwhile just 15 per cent of those in the control group, who had not received the therapy, reported improved sleep.

On seeing the results, 70 per cent of those in the control group requested that they also be given the same treatment.

What did the therapy session teach these patients? Among other things it taught them what Ellis called the 15 minute rule.

If you cannot fall asleep within fifteen minutes, get up and get out of bed. You want to associate your bed primarily with sleep, not with the inability to fall asleep:

The therapy session covered sleep education and individual differences in 'sleep need' at different times of life.

Professor Ellis then introduced the principle of sleep restriction, which encourages the individual to only spend time in bed needed for sleep.

Using their recorded sleep diaries, the individuals were then prescribed a time to go to bed and a time to rise to improve their sleep efficiency.

Professor Ellis explained people often felt sleepy, but tossed and turned when they actually went to their bedroom, meant they were lying in bed feeling angry.

He coached them to lie for 15 minutes, but if they still could not sleep, they should leave the bedroom.

He said: ‘We’re trying to break the association between the bedroom being somewhere you can’t sleep. So that there’s only one stimulus and one response: bedroom equals sleep.

Simple, easy, low-cost, demonstrably effective therapy.

Now you know why cognitive and behavioral treatments have superseded psychodynamic psychotherapy and even medication.


1 comment:

Ares Olympus said...

re: The bad part is that Ellis’ treatment involves one session of cognitive therapy. You heard it right, one session of one hour. As I said, many therapists will greet this news with a mix of elation and chagrin. ... Now you know why cognitive and behavioral treatments have superseded psychodynamic psychotherapy and even medication.

It good and sounds promising, but I don't know why you have to project personal motives of therapists, as if they only see patients as cash cows and will be disappointed that a majority of patients might have problems with simpler solutions and only need one session.

And if its really that simple, surely it can be explained in a self-help book, and then sleep therapists can refocus their attention on the harder cases, the ones that are not solved in one hour.

Anyway, I'd imagine the key is to observe enough patients to see who responds well, and who doesn't and see if you can more quickly identity those for whom this cognitive therapy will work. Although some good advice can maybe help everyone regardless of insomnia so it might really be a quick and harmless treatment for all.