Epidemic of Insufficient Sleep
According to 2012 information from the Centers for Disease Control and Prevention (CDC), approximately 50 to 70 million American adults have a sleep-wakefulness disorder. In fact, insufficient sleep has been categorized as a public health epidemic.
Types of Sleep Disorders
The American Psychiatric Association identifies three categories of sleep disorders. These are:
1. Dysomnias: These sleep disorders impact the amount, quality, and/or timing of sleep. This class of disorders includes insomnia (inability to sleep), hypersomnia (getting too much sleep), and circadian rhythm sleep disorder.
2. Parasomnias: These sleep disorders lead to undesirable behavioral or physiological events that occur while sleeping; they are commonly divided into those that are present during Rapid Eye Movement (REM) sleep, and those that are present during Non-REM (NREM) sleep. This class of disorders includes nightmare disorder, sleep terror disorder, and sleep walking disorder.
3. Secondary sleep disorders: These sleep disorders are caused by a physical illness or psychological distress, or are substance induced.
Insomnia is one of the most common sleep disorders in the U.S.; it is present in approximately 30–40% of the general population, and in up to 66% of the primary care and psychiatric population. In simple terms, insomnia is the inability to get sufficient quality sleep in an efficient manner; it presents itself as having difficulty falling asleep, experiencing frequent or prolonged awakenings during sleep time, and/or having short overall sleep durations (Hales, Yudofsky & Gabbard, 2008). Not only does insomnia affect a person’s sleep, but it also impacts his/her waking life through lack of sleep, as evidenced by some of the common complaints that insomniacs have, including depression, fatigue, and trouble concentrating.
Most of us are familiar with the existence of sleeping pills. But did you know that sleeping pills, although proven effective, should only be taken with precaution and they can have several serious side effects? So, for those who are experiencing trouble sleeping and would rather try a non-pharmacological approach, there are some suggestions.
Behavioral and Psychological Treatment
While there may be a wide variety of behavioral and psychological treatments available for insomnia patients, in the last decade there seems to be substantial evidence for the efficacy of cognitive-behavioral therapy for insomnia, or CBT-I (Smith and Perlis, 2006). CBT-I is an empirically validated cognitive-behavioral intervention that incorporates several facets:
· Stimulus control, which entails reconditioning the bedroom environment in order to reinforce its purpose as a place for sleep.
· Sleep restriction therapy, which initially increases sleep deprivation in order to train the body to maintain adequate sleep efficiency (total sleep time/time in bed).
· Relaxation skills, which reduce sleep-inadequate states of arousal.
· Multi-component CBT-I, which commonly integrates other behavioral interventions with cognitive restructuring techniques in order to modify maladaptive sleep-related beliefs.
Have you ever had any of these sleep-related problems? Maybe you experience chronic sleeplessness or you’ve even been diagnosed with a sleep disorder. Perhaps someone close to you suffers from insufficient sleep, which can affect the wellbeing of everyone around him or her. Does CBT-I or any of the techniques it incorporates sound like something that might be helpful to you or anyone you know?
Hales, R.E., Yudofsky, S.C. & Gabbard, G.O. (2008). Textbook of Psychiatry, 5th ed. The American Psychiatric Publishing: Arlington, VA.
Smith, M.T. & Perlis, M.L. (2006). Who is a candidate for cognitive behavioral therapy for insomnia? Health Psychology, 25, 15-19.