Insomni A Common And Overlooked Sleep Problem

Cognitive behavioral therapy for insomnia is a recent framework developed to address the dysfunctional cognitions and behaviors that contribute to poor sleeping patterns. Insomnia often presents as a comorbidity to a medical or psychiatric disorder, but may also be an isolated diagnosis. According to research studies, benzodiazepine-receptor agonists (BzRAs) and cognitive behavioral therapy (CBT) are the two most effective therapies for treatment and management of insomnia. And while both treatments are beneficial for short-term management of insomnia, CBTi produces long-term sustained benefits with no side effects thus being more advantageous that prescription drug use only. CBTi involves five components: stimulus control, sleep restriction, relaxation training, cognitive therapy and sleep hygiene education. Because CBTi is a fairly new approach, trained professionals may be difficult to find; creative delivery of therapy through telephone or Skype appointments may be necessary.

In my paper, I will tackle insomnia from various perspectives: definitions, types, causes, effects, and means of solutions.

In 2007, Prash, Siversten, and Nordhus, made an interesting argument that addressed the limitations of cognitive behavioral therapy for sleep disorders in older adults. They mentioned the lack of CBT trained health officials in the medical industry, making it difficult for someone in need to access CBT easily. They also mention the lack of well-defined guidelines that define an optimum number of treatment sessions and the optimum length of these treatment sessions for sleep disorders. It also is unclear how long CBT may continue to be beneficial for malfunctioning behavior after treatment sessions have been

Ebben, M. R., & Narizhnaya, M. (2012). Cognitive and Behavioral Treatment Options for Insomnia. Mount Sinai Journal Of Medicine, 79(4)

The epidemiological study included data from 1,074 college students. The data consisted of sleep diaries and questions assessing mental health topics, such as stress, depression and anxiety. The results demonstrated that those with insomnia also were more likely to experience worse cases of stress, depression, and anxiety. This epidemiological study demonstrates a unique factor – insomnia – in the role of poor mental health, which can be brought into discussion at the community meeting. Many people and students know insomnia is an issue, but they just view it as a normal part of the college

Insomnia can be defined as a purpose or apparent complexity in falling and staying asleep. Dissimilarities in variables used for measurement sleep-onset time, time asleep, and time awake by some, sleepiness, irritability, or other impairment of daytime function by others, make difficult comparisons between studies. The insomnia treatments for which there is confirmation of efficacy include sleep restriction, in which the patient is instructed to remain in bed only as long as he is actually sleeping, stimulus control no activities in the bedroom except sleep and sex, and a variety of relaxation methods, particularly in the circumstance of multimodal sleep clinics (Rowe, 1995).

Sleep disturbances were measured by the Pittsburgh Sleep Quality Index, a 17 question questionnaire that allowed the participants to self assess their sleep qualities (Taylor et al., 2015). According to the study (Taylor et al., 2015) phenotypic analyses resulted in “Paranoia, Hallucinations, and Cognitive Disorganization displayed moderate, significant correlations with both sleep measures. Negative Symptoms and Anhedonia correlated less strongly, while Grandiosity did not show significant correlations” (p.677). The study found that hallucinations and paranoia compared to cognitive disorganization had a positive correlation with sleep disturbances (Taylor et al.,

Narcolepsy is characterized by four classic symptoms: “excessive daytime sleepiness (EDS), cataplexy, hypnagogic hallucinations, and sleep paralysis” (Dauvilliers, Beziat, Pesenti, Lopez, Barateau, et. al, 2017 p. 1358). As previously discussed, the study conducted by Lišková consisted of six unrelated measurements and surveys based on sleep routine and personality conducts such as anxiety and dissociative tendencies. It is obvious that measures in sleep disorders are widely disorganized and consist of tests and questionnaires defined as relevant by the researchers. As means of standardizing and validating the Narcolepsy Severity Scale (NSS), researchers Dauvilliers, Beziat, Pesenti, Lopez, Barateau, et. al developed a concise self-report standardized test to measure the four classic symptoms and their severity. A study consisting of 175 adults diagnosed with narcolepsy was executed to determine the validity and reliability of the NSS. The NSS measured participants before, during, and after treatment. Compared to the study of SP in university students, this study included a control group. The control group consists of seventy narcolepsy patients without treatment. One major setback to the NSS thus far is that the standardized test was not administered to children. It is likely that the questions and self

I have always been enchanted by the idea of sleep. As a child, I laid in bed attempting to understand why I was unable to fall asleep. I knew I wasn’t the only one, but the snoring of my family convinced me otherwise. Biology taught me to understand genetics and environmental cues, but they were unable to explain to me how my sleep pattern was different. Unable to figure the cause of my sleep problems, I delved into self-treatments instead. Curiosity for knowledge in sleep therapy prompted my interest in understanding sleep consequences and health.

A Pilot Randomized Controlled Trial of the Effects of Cognitive-Behavioral Therapy for Insomnia on Sleep and Daytime Functioning in College Students. (Taylor, et al. 2014)

110). People who don 't sleep enough may have a hard time concentrating and function. Insomnia consists in "difficulty initiating or maintaining sleep or nonrestorative sleep causing significant functional impairment (Reeve et al., 2015, p. 98). It may affect how the person perceives the environment and increase the formation and prolongation of persecutory ideation (Reeve et al., 2015, p. 108). The clinical study demonstrated that treatment of insomnia using cognitive behavioral therapy and ECT (electroconvulsive therapy) can reduce paranoid episodes and improve sleep (Reeve et al., 2015, p. 110). Reeve et al., (2015) states that "melatonin inhibits dopamine release, increases dopamine turnover, and alters dopamine receptor activation" (p.111). Patients diagnosed with sleep disorder need to follow a plan of treatment to avoid complications, such as paranoia, depression, and other psychotic disorders.

Medicine is a common treatment for insomnia, but the effectiveness of medicine remains uncertain. It is unclear whether medicine has profound improvements in sleep or whether residual symptoms may hinder functioning more. The presence of residual symptoms has shown an association with an additional day of unrestful sleep.15 Yet, medicine has shown improvements in sleep and functioning, although weaker in comparison to CBT15 and Mongolian medical acupuncture.11 Bo et al. directly studied the relationship between acupuncture and medicine,11 while Morin et al. used the relationship between CBT alone or with medicine.13 Morin et al. lacked a medicine only group, but instead furthered their study to examine whether further treatment or no treatment in both groups were effective or not.13 Conflicting with Fitzgerald et al., Morin et al. showed tapering medicine in the extension group to show less improvement in functioning.13 Cancelation of medicine and continuation of CBT would have stopped the presence of residual symptoms and therefore would have shown improvement, but was not the case. Although both CBT and medicine were both effective in improving sleep and daytime functioning, only CBT showed significant reductions in anxiety, depression, and

Insomnia is another sleep disorder that has an effect on the daily lives of others. There are four different types of insomnia that a person may have: difficulty falling asleep, difficulty staying asleep, waking up too early, and Sleep State Misperception. Sleep State Misperception occurs when a person gets a full night sleep, but they feel like they have not gotten any sleep at all. Insomnia can also be classified into three different categories: transient insomnia, short-term insomnia, and chronic insomnia. Transient insomnia occurs only a few nights, short-term insomnia occurs up to four weeks, and chronic insomnia happens most every night for a month or longer. It is common for most everyone to suffer from short-term insomnia at some point

Morin and Benca (2011) citing the American Academy of Sleep Medicine state that recognizes multiple subtypes of insomnia, of which the most prevalent are psychophysiological, paradoxical and idiopathic insomnia. Psychophysiological insomnia is thought to be an outcome of conditioned excitation which is more common among patients who are psychologically and physiologically more prone to sleep disorders. Such persons are more susceptible to overreact to daily irritants and sleep quality is observed to alter greatly different nights. Patients who beef about low sleep quality without proper evidence of such complaints in screenings are thought to have paradoxical insomnia. Furthermore, Idiopathic insomnia is first observed during childhood and

Sleep deprivation is a common issue among people around the world, and everyone has or will experience it in their life. Not getting enough sleep makes it difficult for the body to function properly. Insomnia is a well-known disorder, mainly known in the United States; one in ten adults suffers from this disorder (Kloc). There are many reasons why people end up with a sleeping disorder, and the most common reason is stress. When people do not have enough sleep they behave differently, and do not make the same choices as if they were fully rested. There are four stages of sleep. The fourth stage, REM (Rapid Eye Movement) sleep is the most important stage of sleeping. A common side effect of BPD (Borderline Personality Disorder) is sleep