Clinical Challenges: Delivering CBT to the Sleepless

November 29, 2018 by gyh3nf@virginia.edu

Few people escape the occasional restless night of tossing and turning, followed by the inevitable crushing fatigue the following day. But for the as many as one in 10 adults who suffer from chronic insomnia, the experience is all too common.

In addition to the short-term harms of excessive daytime sleepiness and dysfunction, chronic insomnia — defined as disrupted sleep that occurs at least three nights a week, lasting for at least 3 months — has been linked in epidemiological studies to an increased risk for obesity, diabetes, heart disease, and other life-threatening chronic conditions

Cognitive behavioral therapy (CBT) has been recognized as the gold standard therapy for adults with insomnia by the American Academy of Sleep Medicine and, more recently, the American College of Physicians (ACP).

In 2016 guideline revisions, ACP recommended CBT alone, without medication, as the first-line therapy for chronic insomnia. A 2015 meta-analysis of 20 randomized, controlled trials involving more than 1,100 participants showed CBT to be an effective therapy for chronic insomnia.

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