Insomnia treatment without pills
CBT should be first choice to treat insomnia – says the American College of Physicians (ACP). CBT is highly effective and doesn’t have the serious side effects of sleeping pills. The ACP released 2 reviews about the best possible treatment for insomnia. Moreover they released new guidelines about insomnia treatment and a summary for patients. The ACP says: All adult patients should receive CBT-I as the first step in treating chronic insomnia.
If CBT-I alone does not help to improve insomnia, patients and clinicians should discuss medicines. Clinicians and patients should make a decision together after discussing the benefits, harms, and costs of medicines. These recommendations are in line with the American Academy of Sleep Medicine (AASM). The AASM endorses CBT as a first-line treatment over medication, too.
Insomnia is a very common condition and is causing a tremendous amount of suffering for patients worldwide. The impact on daily life, work performance and social life might be severe.
Therefore most people want to have a “quick fix”. Just popping a sleeping pill seems very tempting. Without any effort or work all problems should be gone. But unfortunately, like so often in live, there is no quick fix.
Sleeping pills can be used under control of a psychiatrist on short term basis only. Most of them will lose effectiveness over time and they come with serious side-effects. Most sleeping pills are addictive on long term basis. Other side effects mentioned by the ACP are cognitive and behavioral changes and infrequent but serious harms.
“Sometimes we forget that sleep medications have the potential for serious side effects in some patients, while cognitive behavioral therapy is very low (risk) to patients,” said Dr. Wayne J. Riley, ACP president.
CBT (Cognitive Behavioral Therapy) is a form of psychotherapy used for many different conditions including insomnia. Usually only a limited number of sessions is required. The sessions are most often on weekly basis and people will receive “homework”. CBT for insomnia is not what most people associate with psychotherapy (laying on a bench talking about the childhood). It is very much focused on the sleep problem itself and psychologists are using different techniques to tackle it, such as “stimulus control” or “sleep hygiene”.
“The evidence is clear that CBT and sleep hygiene can be long lasting, life long, durable and delivered at a lower cost,” said Dr. Riley, who is also affiliated with Vanderbilt University in Nashville.