Cognitive behavioral therapy offers drug-free method for the treatment of insomnia

Insomniacs watery eyes well aware that sleep problems are not limited to night hours. In fact, people who have difficulty falling or staying asleep often feel lousy all day.

Many people with insomnia turn to sleeping pills, which often have undesirable side effects. Few know about the as effective therapy that targets the cause of insomnia without drugs.   

Called cognitive behavioral therapy for insomnia, or CBT-i therapy, talk therapy teaches short term people change thinking patterns and unproductive habits that stand in the way of sleep a good night. While this therapy can "cure" insomnia, will not give you the tools to better manage.

In an opinion article in the Annals of Internal Medicine this week, the researchers combined data from 20 different trials of CBT-i which more than 1,100 people with chronic insomnia. On average, people treated with CBT-I almost fell asleep 20 minutes faster and spent 30 minutes less awake during the night compared to those who undergo CBT-i.

These improvements are as good or better than those observed in people taking sleeping prescription drugs such as zolpidem (Ambien), eszopiclone (Lunesta). And unlike drugs, the effects of CBT-i lasts even after the end of therapy, at least six months, according to a study.

Dr. Stephen Amira, a psychologist at Harvard-affiliated Brigham and Women's Hospital who specializes in CBT-i, says many of his patients have tried sleeping pills in the past but are worried or concerned about the side effects depending too them. "They seek a natural response to give them control over their sleep without having to depend on drugs," he said.

Learning to sleep

What is CBT-i imply? Normally it will meet with a therapist once a week for an hour, for six to eight weeks. It could complete a sleep diary and learn strategies to help you change the way you sleep.A common recommendation of CBT-i is out of bed and do something relaxing if you do not sleep within 20 minutes of rotation. The idea is to associate the bed of relaxation and comfort, no frustration and concern.

Learn relaxation techniques such as mindfulness meditation (which can improve insomnia itself, as I described in a previous post) is another key element of CBT-i. Being able to evoke a relaxed state of mind is especially beneficial for those suffering from insomnia because, as says Dr. Amira, "sleep is one of the few things in life that becomes more difficult and more easy, you work at it. "People with insomnia tend to also be concerned with sleep and apprehension about the consequences of sleep deprivation - a phenomenon known as "insomniaphobia" by the sleep specialist Dr. John Winkelman Harvard. A therapist can help you replace negative thoughts (such as "I will be tired, I'm having a bad day at work tomorrow!") With more positive ("My job does not depend on the amount of sleep I get this night" ).

Most health insurance plans cover the TCC-i, which is under the coverage of mental health. Only one problem: not many therapists are trained in this particular type of talk therapy. Even in the medical mecca of Boston, only five doctors offer CBT-i.

You can find a list of certified specialists across the country from the American Board of Sleep Medicine and the Society of Behavioral Sleep Medicine. If therapy face-to-face is not an option, you can purchase an online version of the technique. The best studied program is called Healthy Sleep Using the Internet, or Shuti (www.shuti.me). A study funded by the government to test the effectiveness of Shuti in people with insomnia - including those who have other medical conditions - is currently under construction.