Chronic Insomnia? Try a Behavior Therapy

Daily Herald (Arlington Heights, IL), May 9, 2016 | Go to article overview

Chronic Insomnia? Try a Behavior Therapy


Byline: Lauran Neergaard AP Medical Writer

Tossing and turning night after night?

Don't automatically reach for the pill bottle.

New guidelines say the first choice to treat chronic insomnia should be cognitive behavioral therapy -- a way to condition your body to slumber again.

It takes more time and effort than popping a pill, but the American College of Physicians said recently the method known as CBT can be effective and doesn't carry the side effects of medication, a recommendation intended to spur primary care doctors to prescribe the step. If it doesn't work, then doctors could consider adding a drug.

"Prescribing a sleeping pill is not the desirable first step," said the group's Dr. Thomas Tape, chief of general internal medicine at the University of Nebraska Medical Center. Yet for many primary care physicians, the behavioral approach "wasn't really on our radar screens," he said.

There are challenges, including finding health workers who are trained to deliver CBT for insomnia. Nor is it always covered by insurance, notes an editorial published along with the recommendation in Annals of Internal Medicine. Here are some things to know:

The right sleep

Adults ages 18 to 60 are supposed to sleep at least seven hours a night for good health. Cheating sleep can increase the risk of health problems from high blood pressure to obesity to fatigue-caused car crashes.

When insomnia lasts

People often get too little sleep because of lifestyle or job circumstances.

That's different than trying to sleep and failing.

Many bouts of insomnia that last several weeks to a month or two come about because of stress or an illness.

But between 6 percent and 10 percent of adults meet the criteria for an insomnia disorder: They suffer daytime problems because of difficulty falling asleep or staying asleep at least three nights a week for three months or more, and it's not explained by some other disorder.

It's more common among older adults and women.

What is cognitive behavioral therapy for insomnia?

It's far more than sleep hygiene, those common-sense tips to keep the bedroom dark and cool and avoid too much caffeine.

It's all about reconditioning a brain and body away from now-habitual tossing and turning and back to normal sleep patterns, said Duke University clinical psychologist Meg Lineberger. A certified behavioral sleep medicine specialist, she wasn't involved with the new guidelines but hopes they increase patients' access to care. …

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