Cognitive Behavioral Therapy for Insomnia

Dear Colleague,

Insomnia is a common problem, affecting about 10% of the general population and close to 50% of patients seen in primary care practices. Recent data suggests that insomnia can be a precursor to depression and anxiety, and that insufficient sleep is associated with other co-morbidities such as diabetes and obesity.

Since sleep affects everyone, health providers often find themselves caring for patients with sleep complaints, but being unprepared to provide the best possible treatments for these patients. In 2005, the National Institutes of Health (NIH) held a State of the Science conference on insomnia. Experts in the field concluded that behavioral therapies are the most effective and the most enduring treatment for insomnia. Yet there are only a handful of practitioners able to provide behavioral therapies.

This conference is designed for psychologists, psychiatrists, primary care physicians, nurses, social workers, and other health-care professionals who are interested in learning behavioral treatment of insomnia – specifically, cognitive behavioral therapy for insomnia (CBT-I). This one-day course will teach practitioners how to get started with CBT-I, the components of CBT-I including sleep education, stimulus control, sleep restriction, sleep hygiene education, relaxation training and cognitive therapy, and helping patients sleep well over the long-term. In addition, normal sleep, consequences of insomnia, differential diagnoses with other sleep disorders, clinical evaluation of insomnia and pharmacological treatments will be covered. The goal of the conference is to provide up-to-date, clinically relevant information to assist you in delivering quality care for the patient with insomnia.

This is the first time this course is being offered on the West Coast. Please note that the course will be limited to 100 registrants. We hope to see you in April 2012, a beautiful time of year in San Diego, for this highly instructive and exciting exchange of ideas.

Cordially,

Sonia Ancoli-Israel, PhD, CBSM
Conference Co-Director

Jennifer L. Martin, PhD, CBSM
Conference Co-Director

General Facts About Insomnia and its Treatment

Chronic insomnia is defined as difficulty falling asleep, staying asleep or non-restorative sleep that lasts at least one month and results in daytime consequences. Insomnia often coexists with chronic physical and psychiatric conditions, and its prevalence is often higher among patients with these conditions than in the general population. Evidence suggests that insomnia as a feature of chronic disease tends to be more severe and persistent than insomnia that does not occur in the context of chronic illness. Furthermore, insomnia can have a profound negative impact on patients’ quality of life and overall functioning, and may be associated with greater healthcare resource utilization and absenteeism. In some cases, treatment of the underlying disorder may improve sleep, whereas in other cases, treatment of the sleep symptoms may actually improve the underlying disorder. In addition, chronic insomnia may be a precursor to certain psychiatric co-morbidities.

In 2005, the NIH determined that the best first-line treatment approach for insomnia is cognitive behavioral therapy with a role for pharmacological therapy either as an adjunct or alternative to behavioral treatment. The NIH also determined that there is a shortage of professionals trained in cognitive behavioral therapy for insomnia (CBT-I).

OBJECTIVES

Upon completion of the activity, participants should be able to:

Examine the definition and consequences of insomnia
Distinguish the relationship between insomnia and co-morbidities
Identify the differential diagnosis of insomnia, considering other co-morbidities and sleep disorders
Describe the rationale and empirical support for treating insomnia with CBT-I
Identify appropriate patients for CBT-I
Appropriately apply concepts of CBT-I and pharmacological treatments with insomnia patients