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Why cognitive behavioral therapy (CBT) should be first-line treatment for chronic insomnia



Cog­ni­tive behav­ioral ther­a­py offers a drug-free method for man­ag­ing insom­nia (Har­vard Health):

Many peo­ple with insom­nia turn to sleep­ing pills, which often have unwant­ed side effects. Few of them know about an equal­ly effec­tive ther­a­py that tar­gets the root cause of insom­nia with­out med­ica­tions. Called cog­ni­tive behav­ioral ther­a­py for insom­nia, or CBT‑i, this short-term talk ther­a­py teach­es peo­ple to change the unpro­duc­tive think­ing pat­terns and habits that get in the way of a good night’s sleep…

In a review arti­cle in this week’s Annals of Inter­nal Med­i­cine, researchers com­bined data from 20 dif­fer­ent tri­als of CBT‑i involv­ing more than 1,100 peo­ple with chron­ic insom­nia. On aver­age, peo­ple treat­ed with CBT‑i fell asleep almost 20 min­utes faster and spent 30 few­er min­utes awake dur­ing the night com­pared with peo­ple who didn’t under­go CBT‑i.

These improve­ments are as good as, or bet­ter than, those seen in peo­ple who take pre­scrip­tion sleep med­ica­tions such as zolpi­dem (Ambi­en) and eszopi­clone (Lunes­ta). And unlike med­ica­tions, the effects of CBT‑i last even after the ther­a­py ends—at least six months, accord­ing to one study.”

Study: Cog­ni­tive Behav­ioral Ther­a­py for Chron­ic Insom­nia: A Sys­tem­at­ic Review and Meta-analy­sis (Annals of Inter­nal Med­i­cine). From the abstract:

  • Back­ground: Because psy­cho­log­i­cal approach­es are like­ly to pro­duce sus­tained ben­e­fits with­out the risk for tol­er­ance or adverse effects asso­ci­at­ed with phar­ma­co­log­ic approach­es, cog­ni­tive behav­ioral ther­a­py for insom­nia (CBT‑i) is now com­mon­ly rec­om­mend­ed as first-line treat­ment for chron­ic insom­nia.
  • Pur­pose: To deter­mine the effi­ca­cy of CBT‑i on diary mea­sures of overnight sleep in adults with chron­ic insom­nia.
  • Study Selec­tion: Ran­dom­ized, con­trolled tri­als assess­ing the effi­ca­cy of face-to-face, mul­ti­modal CBT‑i com­pared with inac­tive com­para­tors on overnight sleep in adults with chron­ic insom­nia, with stud­ies of insom­nia comor­bid with med­ical, sleep, or psy­chi­atric dis­or­ders exclud­ed.
  • Con­clu­sion: CBT‑i is an effec­tive treat­ment for adults with chron­ic insom­nia, with clin­i­cal­ly mean­ing­ful effect sizes.

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As seen in The New York Times, The Wall Street Journal, BBC News, CNN, Reuters,  SharpBrains is an independent market research firm tracking how brain science can improve our health and our lives.

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