TABLE 3-2 Psychological and Behavioral Treatments for Insomnia

Therapy

Description

Stimulus control therapy

A set of instructions designed to reassociate the bed/bedroom with sleep and to reestablish a consistent sleep-wake schedule: Go to bed only when sleepy; get out of bed when unable to sleep; use the bed/bedroom for sleep only (e.g., no reading, watching TV); arise at the same time every morning; no napping.

Sleep restriction therapy

A method to curtail time in bed to the actual sleep time, thereby creating mild sleep deprivation, which results in more consolidated and more efficient sleep.

Relaxation training

Clinical procedures aimed at reducing somatic tension (e.g., progressive muscle relaxation, autogenic training) or intrusive thoughts (e.g., imagery training, meditation) interfering with sleep.

Cognitive therapy

Psychotherapeutic method aimed at changing faulty beliefs and attitudes about sleep, insomnia, and the next-day consequences. Other cognitive strategies are used to control intrusive thoughts at bedtime and prevent excessive monitoring of the daytime consequences of insomnia.

Sleep hygiene education

General guidelines about health practices (e.g., diet, exercise, substance use) and environmental factors (e.g., light, noise, temperature) that may promote or interfere with sleep.

SOURCE: Morin (2005).

maintaining sleep throughout the night (Morin, 2005; Benca, 2005a). It is still unclear whether hypnotics lead to dependence. It is suggested that they should not be taken for more than 10 days in a row; however, recent studies suggest that hypnotics do not always lead to dependence (Hajak et al., 2003; Walsh et al., 2005; Benca, 2005a). There have been no large-scale trials examining the safety and efficacy of hypnotics in children and adolescents. Other pharmacological classes used for insomnia include sedating antidepressants, antihistamines, and antipsychotics, but their efficacy and safety for treating insomnia have not been thoroughly studied (Walsh et al., 2005).

SLEEP AND PSYCHIATRIC DISORDERS

Manifestations and Prevalence

Sleep disturbances are common features of psychiatric disorders. The most frequent types of sleep disturbances are insomnia, excessive daytime



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement