Are you having trouble sleeping lately? Do you suffer from insomnia?
Sleep disorders are common. Various estimates put the prevalence of chronic insomnia in the population somewhere between 10% and 50%. In addition, many suffer insomnia as part of another condition, such as depression or menopause.
While variation is normal and the occasional bad night’s sleep an inevitable fact of life, sleep debt accumulates and frequent sleep deprivation can have a debilitating effect on mental (and physical) health.
Chronic insomnia is defined as problems getting to sleep or staying asleep, at least three times a week, over a period of three months.
Many things can interfere with sleep. There are some physical causes that it is important to rule out but, more commonly, bad habits, stress, alcohol, caffeine, some medications, and poor mental health, contribute to poor sleep.
The Consequences of Not Getting Enough Sleep
Being tired affects us in various ways.
Insomnia is associated with impaired daytime functioning, such as lower cognitive performance, fatigue and mood disturbance. Some people feel more emotional, lose concentration (which can affect memory) and eat more unhealthy foods.
Research has discovered that insomnia is associated with increased risks for serious mental health, such as major depression, and physical problems, such as increased risk for cardiovascular diseases.
Cognitive behavioural therapy for insomnia (CBTi) is the gold standard treatment recommended by the Australasian Sleep Association.
Cognitive Behavioural Therapy for Insomnia (CBTi)
CBTi is recommended as the first-line treatment for chronic insomnia in adults of any age. It has been shown to improve insomnia, both where it is a problem in itself and where it results from other problems. CBTi involves:
- Assessment – Treatment starts with a comprehensive assessment of the client’s symptoms. This should include keeping a sleep diary to monitor your actual sleep/wake routine and how much sleep you are getting. Once you have the information to see how efficiently you are sleeping, then treatment focuses on those strategies that have been proven to be effective.
- Stabilise the system – The first step is to learn how to make your circadian rhythms work for you by introducing regular wake-up times, light exposure and exercise. Circadian rhythms regulate our internal clock; they can get more fragile as we age so may need reinforcing more strongly. Learn about your own stages of sleepiness and how to go to bed at the right stage for you.
- Break the habit of poor sleep – Break habits that stop you getting to sleep. Learn how to set up your sleep environment so as to decrease your arousal levels so you can fall to sleep. Use sleep scheduling – the most effective component of CBTi – to limit the time you spend in bed. This helps you go to sleep more quickly and increases the proportion of time in bed asleep.
- Change your beliefs – You may need to change your beliefs and attitude to sleep, because rumination and worry about not getting enough sleep only adds to the problem. If there are particular problems on your mind that are keeping you awake, it would be helpful to talk these through with your psychologist, so that they do not add to the problem.
How Effective is CBTi?
It has been shown that CBTi is at least as effective as drugs in the short term and more effective in the long term, and many people prefer it over taking regular sleep medication. It helps people to understand their sleep patterns better and gives them greater control. We can all improve our functioning, productivity and wellbeing by making sure we get enough sleep.
Author: Dr Katie Trickey, B Sc (Hons), MA (Hons), Doctorate in Clinical Psychology (UK), MAPS.
Dr. Katie Trickey is a Brisbane Clinical Psychologist with a special interest in sleep difficulties. She has worked in both London and Australia, and can provide expert help to people wanting to overcome insomnia.
To make an appointment with Clinical Psychologist Dr Katie Trickey, you can try Online Booking – Mt Gravatt or call Vision Psychology Mt Gravatt on (07) 3067 9129.
- Blom, K. et al. Internet treatment addressing either insomnia or depression, for patients with both diagnoses: a randomised trial. Sleep, 2015; 38(2): 267-277
- Kyle, S. D. et al. Insomnia and health-related quality of life. Sleep Med Rev, 2010;14:69-82.
- Morin & Benca (2012). Chronic Insomnia. The Lancet, 379; (9821): 1129-41
- Riemann, et al. (2017). European guideline for the diagnosis and treatment of insomnia. Journal of Sleep Research, 2017, 1-26.
- Australasian Sleep Association: www.sleep.org.au