Abstract

Intensive sleep re-training is a promising new therapy for chronic insomnia. Therapy is completed over a 24-h period during a state of sleep deprivation. Improvements of sleep and daytime impairments are comparable to the use of stimulus control therapy but with the advantage of a rapid reversal of the insomnia. The initial studies have been laboratory based and not readily accessible to the patient population. However, new smart phone technology, using a behavioral response to external stimuli as a measure of sleep/wake state instead of EEG determination of sleep, has made this new therapy readily available. Technological improvements are still being made allowing the therapy to provide further improvements in the effectiveness of Intensive Sleep Re-training.

Highlights

  • Chronic insomnia is not a trivial disorder in our society

  • The aspects of chronic insomnia that are essential to define the disorder are the daytime impairments associated with the sleeping difficulties

  • These patients, withpatients, mainly sleep onset insomnia reporting more than an hour on an hour on average to get to sleep in their home environment, were able to experience more than average to get to sleep in their home environment, were able to experience more than 40 rapid

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Summary

Introduction

Chronic insomnia is not a trivial disorder in our society. Ongoing frequent difficulties initiating sleep and/or getting back to sleep after awakenings during the night may be troublesome at best. The aspects of chronic insomnia (duration >3 months) that are essential to define the disorder are the daytime impairments associated with the sleeping difficulties These aspects tend to be the most troublesome and most likely to motivate the sufferer to seek treatment [2]. Behavior therapies are the mainstay of CBT-I, providing the most rapid improvement for the majority of insomnia sufferers [14] These therapies address the maladaptive learning or association process mentioned above that results in hyperarousal while attempting sleep. After the initial period of sleep restriction, the subsequent extension of time in bed is typically associated with reported improvements in daytime functioning and feelings of greater energy [17]. The assumed mechanism of action is the eventual conditioning of a rapid sleep onset and/or return to sleep, reducing the learned hyperarousal of chronic insomnia

Challenges to the Implementation of Behavior Therapies
Translation of ISR to the Home Environment
Distributed Versus Massed Trials
Robust Recovery Sleep
The Experience of Sleep Deprivation
Feedback of Time Taken to Fall Asleep
Effectiveness of ISR on Different Insomnia Phenotypes
Potential Improvements of the Behavioral Response Measure of Sleep Onset
Development of THIM Wearable Device for Sleep
Other Future Research Projects
Findings
10. Conclusions

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