Insomnia III

Abstract

Cognitive behavioral therapy (CBT) for insomnia comprises a collection of relatively brief, empirically validated treatments for this common disorder. The main CBT treatments described in this chapter are relaxation approaches (a collection of methods designed to induce physiological and experiential calm by quiescent self-inquiry), stimulus control (eliminating non-sleep activities from the bedroom), sleep restriction (abrupt reduction of time in bed to match total sleep time), sleep compression (gradual reduction of time in bed to match total sleep time), sleep hygiene (plan daily activities to create a sleep-conducive environment), and cognitive therapy (managing sleep-related, self-defeating worry). A variety of treatment implementation strategies are described, including multi-component interventions, group therapy, self-help methods, and delivery in primary care. The strong scientific foundation of CBT for primary, comorbid, hypnotic-dependent, and late-life insomnia is reviewed. We conclude that CBT for insomnia is an effective, versatile approach. Lastly, we identify possibilities for future research including more careful attention to daytime functioning variables and developing more effective strategies for combined CBT/pharmacological treatment.