Cognitive Behavioral Therapy Helps Older People With Insomnia

Cognitive behavioral therapy helps older patients with insomnia change their thinking, behavior, and emotional responses related to sleep issues, which can improve their insomnia.

Insomnia is the most common sleep problem in adults -- as many as 30 percent to 50 percent of people report having trouble sleeping. For older adults, insomnia can often be chronic and is linked to other serious health conditions. Older adults who have difficulty sleeping are also at higher risk for depression, falls, stroke, and trouble with memory and thinking. They also may experience a poorer quality of life.

Insomnia | Sleeping Difficulty - Symptom Evaluation
Insomnia may be due to physiological, psychological, physical or environmental factors. Insomnia should be treated promptly in order to improve the quality of life and prevent other health problems.

‘Cognitive behavioral therapy for insomnia (CBTI) is a type of talk therapy that is considered highly effective for treating older adults with insomnia.’

During CBTI sessions, therapists work with patients to help them .

Although treatment guidelines recommend CBTI as a primary therapy for older adults with insomnia, many people do not receive it because only a limited number of therapists have CBTI training. Primary care providers also may believe that it is challenging to motivate older adults to see a therapist for insomnia.

To address these problems, a team of researchers developed a new CBTI treatment program. The program uses trained "sleep coaches" who are not therapists. They learn how to give CBTI using a manual and have weekly, supervised telephone calls with a CBTI psychologist. The program requires brief training for the sleep coaches, who are social workers or other health educators.

Epworth Sleepiness Scale
Measure your daytime sleepiness using this simple interactive tool, based on Epworth Sleepiness disorder Scale. Excessive Daytime Sleepiness is a type of hypersomnia characterized by persistent sleepiness and lack of energy.

In their study published in the Journal of the American Geriatrics Society, the researchers assigned 159 people to one of three treatment groups. The participants were mostly white male veterans who ranged in age from 60- to 90-years-old.

The first two groups of people received CBTI from sleep coaches (who had a master's degree in social work, public health, or communications) who had attended the special CBTI training. One group of people received one-on-one CBTI sessions with the sleep coach. The second group also received CBTI, but in a group format. People in the third group (the control group) received a general sleep education program, which also consisted of five one-hour sessions over six weeks. These people did not receive CBTI from sleep coaches.

Quiz on Obstructive Sleep Apnea
Do you feel sleepy all day despite sleeping normal hours? One of the possible reasons for this sleepiness could be obstructive sleep apnea. Test your knowledge on obstructive sleep apnea by taking this quiz.

During the five one-hour sessions over a six-week period, in both the one-on-one and group sessions, the coaches counseled participants about improving sleep habits and how to avoid practices that can make it harder to sleep well. This involved learning techniques such as using the bed only for sleeping, not for watching TV or reading, limiting the amount of time in bed so sleep becomes more consolidated, and other techniques. In both groups, the sleep coaches also had one weekly telephone call with a CBTI-trained psychologist to review how the participants were doing with the program.

Researchers collected information about the participants' sleep habits at the beginning of the study and one week after treatments ended. They also followed up with participants six months and one year later.

Individual Beliefs can Worsen Insomnia
Our beliefs can play an important role in worsening insomnia and pain experiences in people with back pain, fibromyalgia and arthritis, found a research team.

Following their treatment, people with insomnia who received CBTI from a sleep coach (either one-on-one or in a group) had lessened their sleep problems significantly, compared to people in the control group. Improvements included:

Participants took about 23 minutes less to fall asleep

Participants' awake time was about 18 minutes less once they fell asleep

Participants' total awake time was about 68 minutes less throughout the night

Participants also reported that the quality of their sleep had improved

Six and 12 months after treatment, the participants in both CBTI treatment groups maintained most of their sleep improvements.

The researchers said that improvements in sleep were about the same whether people worked with the sleep coach in one-on-one or group sessions.

According to the researchers, since the study was mostly limited to male veterans, the results might not be the same for women or for non-veterans. The researchers concluded that this CBTI treatment program, delivered by sleep coaches, improved sleep quality for older adults.

Source-Eurekalert