Tips for Treating 'Acute Insomnia'

Martin Reed | July 17, 2017

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Can group-based CBT effectively treat acute insomnia?

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Cognitive behavioral therapy for insomnia (CBT-I) is recommended as a first-line treatment for insomnia by the National Institutes of Health and the American Academy of Sleep Medicine. However, it is not always accessible, or affordable.

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How does CBT-I work?

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CBT-I involves teaching techniques that help increase sleep drive while reducing negative sleep-related thoughts and behaviors. At the same time, it helps address stress and anxiety related to sleep, the bedroom, and the bedtime routine.

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Why doesn’t every insomniac seek CBT-I?

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Although recognized as an effective insomnia treatment, CBT-I requires dedication and commitment over a period of around six to eight weeks. As a result, a lot of insomniacs quit before treatment ends or fail to adhere to the treatment.

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How to make CBT-I easier and more effective

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Studies suggest that abbreviated versions of CBT-I may also be effective, particularly when insomnia has only just begun. However, there has been no widespread implementation of these shorter-format courses as yet.

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The benefit of treating insomnia early

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Treating insomnia early, while the condition is still in its acute phase, can help prevent the development of long-term, chronic insomnia. Early intervention can also allow for shorter treatments since the negative thoughts and worries that act as obstacles to sleep are less embedded in the mind and are typically less severe.

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The “single-shot” insomnia intervention

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A 2015 study found that a single 60 minute - 70 minute face-to-face CBT-I session, along with a self-help pamphlet, improved sleep in 60 percent of those who had insomnia for less than three months.

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Would a single-shot group-based CBT-I session work?

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Although the single-shot intervention appeared to be successful, it still comes at a relatively high financial cost and requires clinical resources that are already under pressure. This led researchers of a 2017 study to investigate whether the intervention can be successful in a group environment.

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Group-based CBT-I versus individual CBT-I

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In the 2017 study, group therapy subjects were treated in groups of four and the results were compared with those from participants who underwent a single one-on-one treatment session. All participants had acute insomnia (i.e., they had insomnia for less than three months).

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Group-based CBT-I comparable to individual CBT-I

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Researchers found that, in terms of insomnia symptoms and treatment outcomes, group treatment was comparable to individual treatment. With that being said, only 54 percent of those in the group session adhered to the sleep restriction component of CBT-I, compared to 92 percent in the individual session.

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The importance of addressing insomnia early

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As pointed out by the authors of the study, since participants only had insomnia for a short period of time, there may have been some natural remission — and the small treatment groups mean we can’t say for sure whether the group treatment would be effective in larger groups. But the study does appear to confirm that addressing insomnia early is preferable.

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How to improve your sleep when newly diagnosed with insomnia

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Recommendations can be extracted from the techniques used in the single-shot CBT-I sessions. Specifically, make sure you aren’t allotting too much time for sleep, keep a regular sleep schedule, use the bedroom only for sleep and sex, and get out of bed if you can’t sleep. Replacing negative sleep thoughts with positive sleep thoughts can also help.