Sleep Disorders

What is Behavioral Sleep Medicine?

Behavioral Sleep Medicine (BSM) is a branch of health psychology that often combines behavioral approaches with cognitive techniques. Approaches do not involve medications, but interventions may be used in conjunction with medications. Many BSM interventions are based on cognitive-behavioral therapy (CBT). CBT is supported by scientific data and has evidence based support for treating a variety of sleep disorders. The focus is on systematically introducing behavioral changes that have been proven to improve sleep. Most CBT therapies for sleep disorders are brief, involving an evaluation and a limited number of treatment visits.


Behavioral Sleep Services Provided by Drs. Gentry and Hildebrandt:

Treatment of Insomnia – Cognitive Behavior Therapy for Insomnia (CBT-I) is a multi-component treatment that combines several clinically proven interventions tailored to each patients particular needs. According to the American Academy of Sleep Medicine, CBT-I is a standard treatment for chronic insomnia. A sleep diary completed at home for 1-2 weeks is often part of the evaluation. There are several benefits of CBT-I, which include the following:

  • It’s a short term treatment (often 4 or 5 sessions),
  • There is minimal or no side effects,
  • Research has shown improvements in sleep are as good, and in some cases, better than the most effective sleeping pills,
  • Treatment effects are long lasting,
  • It can be successfully used to treat insomnia occurring with many other medical (CPAP treatment) or psychiatric disorders.

How do I know if Cognitive Behavior Therapy for Insomnia (CBTI) is Right for Me?

There is no way to know how succesful any treatment is likely to be until you have been evaluated by a psychologist that has training in behavioral sleep medicine. Research has shown that a majority of individuals with insomnia will experience significant improvements in sleep with almost half of those experiencing eradication of their insomia with CBTI.

Reference:
Morin et.al Cognitive Behavior Therapy, Singly and Combined with Medication, for Persistent Insomnia: A Randomized Controlled Trial. Journal of the American Medical Association 2009; 301; 2005-2015.

Click on the link to watch a video produced by the Harvard Medical School Division of Sleep Medicine on meeting with a sleep psychologist and CBTI treatment:

www.healthysleep.med.harvard.edu/healthy/getting/overcoming/consultation

Other Behavioral Sleep Services Provided:

Behavioral Interventions for Adherence and Treatment of CPAP – Some people have claustrophobic reactions to CPAP and may not understand why they should wear it. Treatment can help you to learn to sleep well with your CPAP.

Treatment of Nightmares – Imagery Rehearsal for Nightmares (IRT) is an effective, non-drug approach to nightmare treatment.  IRT has been shown to be effective with a wide range of patients, from those who suffer from distressing dreams on a regular basis to those who have nightmares related to Post-Traumatic Stress Disorder (PTSD). IRT can also be adapted for children.

Treatment of Circadian Rhythm Disorders “Night Owls” – Treatment is formulated based upon each patient’s unique experience, but treatment may include use of natural or artificial bright light to help reset the biological clock, use of melatonin and CBT-I principles.  Although each person’s situation is different, treatment can generally be completed in 3-6 sessions.  


Click on the link to see more about insomnia and treatment from the National Sleep Foundation and American Psychological Association:

sleepfoundation.org/insomnia/

Too Stressed to Sleep