Cognitive-Behavioural Therapy (CBT) for Insomnia Symptoms
CBT is a psychological treatment that has been shown to be useful for insomnia symptoms, only within the last two decades. It is effective as a stand-alone therapy for some disorders, and as an adjunct to medical treatment in others. At present, the strongest outcome data relates to the effectiveness of CBT in treating primary insomnia. Recent research shows that CBT is also effective for treatment of insomnia that is secondary to mood disorders (such as depression), anxiety disorders, chronic pain, cancer and some other medical and psychological disorders.
Results show that CBT is, at minimum, as effective as medical treatment, with the added advantages of having no side-effects and significantly longer duration of benefits than medication, after the treatment is ceased (Perlis & Lichstein, 2003).
Why CBT for Insomnia Symptoms?
Over recent years a number of studies have compared CBT to other treatments for insomnia, and have consistently found that CBT achieves better results. Here is a summary of some of those findings:
- CBT is a multi-modal treatment that is more effective than single-mode treatments such as relaxation training, education and pharmacotherapy (Wang, Wang & Tsai, 2005).
- Insomnia is perpetuated by a number of cognitive and behavioural factors, therefore CBT has become the treatment of choice for insomnia (Edinger & Means, 2005).
- CBT produces significantly greater sleep improvements than: no treatment, pharmacologic and non-pharmacologic placebo interventions, and progressive relaxation therapy. Research that has included post-treatment follow-ups of 3 to 24 months has found that the improvements in sleep are maintained over time (Edinger & Means, 2005).
- A review of research on the effectiveness of CBT as a treatment for primary insomnia found that CBT reliably reduces the time taken to fall asleep, increases total sleep time and reduces both the number of awakenings during the night and the amount of time spent awake during the night (Morin, Bastien & Savard, 2003).
- This review found that the improvement in time taken to fall asleep and the amount of time spent awake during the night was maintained at 12, 24 and 36 months after treatment. Research that compared insomnia treatment by CBT and pharmacotherapy, both individually and in combination, found that treatment with CBT alone was the most effective method (Jacobs, Pace-Schott, Stickgold & Otto 2004)