Insomnia: Cognitive Behavioral Therapy

Insomnia, also known as sleeplesness, denotes a persistent problem in falling and staying asleep. It is usually followed by daytime sleepiness, irritability, low energy, and sometimes even depression. When insomnia is severe, it can result in increased risk of motor vehicle collisions, due to one falling asleep at the wheel when experiencing daytime sleepiness. Sometimes insomnia can occur independently, but it is more often the result of another, underlying problem. Conditions that may lead to insomnia include hyperthyroidism, heartburn, psychological stress, heart failure, menopause, and certain medications. It may also be caused by a surplus of caffeine, nicotine, and alcohol. Those with sleep apnea or who work night shifts are also at an increased risk of developing insomnia. While it cannot be cured, treatment may help. A sleep study may be conducted on the patient experiencing sleeplessness to diagnose the nature of insomnia, and to dissociate it from other sleep disorders, like narcolepsy. 

Insomnia is very common, affecting more than three million people in the US each year. People over the age of sixty five are more susceptible than younger people. Between 10 and 30 percent of adults will experience insomnia at any given time during their adulthood. It is usually self-diagnosable, and lab tests and imaging are rarely required. Most cases of insomnia are related to lifestyle conditions, such as poor sleep habits, depression, anxiety, lack of exercise, chronic illness, or certain medications. The symptoms are fairly simple: one experiences difficulty falling or staying asleep, with a constant feeling of being unrested throughout the day. 

Treatments for insomnia include improving sleep habits, behavioral therapy, and identifying and treating underlying causes. In some cases, sleeping pills are administered. While these sleeping pills may help, they are often associated with addiction, injuries, and dementia. Additionally, they are not recommended for more than four to five weeks, therefore not providing a long-term solution to getting more and healthier sleep. In this article, we will be discussing cognitive behavioral therapy, a method of treating insomnia.

Cognitive behavioral therapy (CBT) is a short-term, goal-oriented psychological form of therapy that targets problems with a practical, hands-on approach. Its main goal is to alter thinking patterns and behavior in the individual to steer them away from behaviors and thoughts that may lend themselves to the problem. It is the most widely used evidence-based method of treating psychological disorders in the United States. It is based on the belief that negative thoughts can have a profound physical manifestation, affecting one's being. Studies have shown that CBT alone can be effective in treating anxiety, post-traumatic stress disorder, tics, eating disorders and mild forms of depression. It is recommended in combination with other medication for treating disorders such as bipolar, borderline personality disorder, opioid addiction, and major depressive disorders. 

Cognitive behavioral therapy is undertaken as a method of managing stress and depression. The treatment is used to change one's overall mood over a period of time, since one's mood and behavior can severely affect their sleep patterns, causing them to sleep either too much or too little. It is meant to help problems that cannot be withstood and help lessen these issues. It takes a one-step-at-a-time approach instead of a rounded attack.

Cognitive behavioral therapy is primarily meant for people suffering from stress or conditions of easily provoked anger. It can also help people with panic issues, phobias, eating disorders, obsessive-compulsive disorders, sleeping problems, and problems associated with alcoholism. In some cases, it is used to help chronic fatigue issues and debilitating bowel movements. Although cognitive behavioral therapy may not completely rid one of their chronic illness, it may help alleviate the symptoms and make them easier to manage. 

During the therapy process, one is required to see a doctor once in a week, or biweekly at the very least. The time it takes for the treatment to be effective is approximately twenty lessons, which last from anywhere between half an hour to one hour. One is required to practice 'breaking' with the therapist, or breaking down one's issues into several different, manageable parts. When one works with his or her therapist, he or she should regularly provide feedback to see whether the course of therapy is working for them, what improvements can be made, and what adjustments can be made to suit the individual. The patient-therapist pair should then try out these changes to see if they make any substantial differences to the patient. Every visit, the patient should update the therapist on what is working for them and what isn't. Finally, the therapy's main goal is to teach the individual how to use the skills learned in treatment to change one's lifestyle, avoiding many stressful factors that may affect them. 

The advantages and disadvantages of therapy are evident. The benefits of treatment include:

• In states where medicinal drugs are not available, or when the patient is hesitant to use them, cognitive behavioral therapy can serve as a healthy alternative.
• Cognitive behavioral therapy can be less time-consuming than other methods of treatment.
• The nature of cognitive behavioral therapy is flexible, and therefore can be carried out in different ways and molded to suit the needs of the individual.
• There are a number of sources to aid the process, including books and media.
• After the course of therapy has been completed by the patient, the skills learned in cognitive behavioral therapy can continue to benefit the individual for years to come.

However, there are also a number of disadvantages to cognitive behavioral therapy. These include:

• One is required to be enthusiastic, willing, and committed to the process of therapy. They should be cooperative and hopeful, but not overly expectant: cognitive behavioral therapy is not a miracle worker; it will not cure your illness overnight. The affected individual must be ready to work hard and be patient to overcome their illness in the healthiest, fullest way, and be prepared to follow all instructions of their therapist.
• Lessons will most probably be scheduled at specific times, so attendance is of ultimate importance.
• This type is therapy is not suited to those with disabilities, since the coordination of the brain and body needs to be fairly normal. See your physician for advice on whether your disability renders you unable to undertake cognitive behavioral therapy.
• Willpower is a large component of cognitive behavioral therapy; one needs to want to become better in order for the therapist to be able to help. Therapists have stated that their fastest cases of improvement and recovery have been in cases where the patient has exhibited a strong desire to get better. 

Cognitive behavioral therapy for insomnia is a structured program; it helps you replace thoughts or behaviors that can worsen sleep problems with healthier habits that promote and encourage sound sleep. Unlike sleeping pills, it tackles the root of the problem, allowing you to slip back into a normal cycle of shallow and deep sleep, with appropriate REM cycles. CBT also has no side effects and is a long-term solution, as opposed to sleeping pills. Statistically, it improves sleep in 75% to 80% of its patients and eliminates use of sleeping pills in 90% of its patients. Techniques include stimulus control, daytime relaxation techniques, developing stress-reducing attitudes, and cognitive restructuring techniques.