If you’re someone who can’t sleep at night, or worse, you suffer from insomnia, which Healthline defines as some who “finds it difficult to fall asleep, stay asleep, or both,” then you may be inclined to reach for some sleeping pills.
But, there may be something else you can try that is just as, if not more effective and doesn’t require you to put drugs into your body. Benzodiazepines – a common drug prescribed to those who suffer from insomnia – were found to be the “most common substance found in male overdose deaths in the past 20 years in Australia.”
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As CNN Health reports, a new study, published Wednesday, November 24 in the JAMA Psychiatry journal, has found that “undergoing cognitive behavioural sleep training may help prevent depression in older adults with insomnia.”
Cognitive behavioural sleep training can be likened to therapy, since it teaches you, and gives you the tools to help break any bad habits you might have in order for your mind and body to get into a state where good sleep is made possible.
The study’s author, Dr Michael Irwin, says “some 30% to 50% of older adults complain of insomnia,” a condition that has been proven time and time again can be a major contributor towards suffering from depression.
In order to obtain his findings, Dr Irwin took 291 adult participants all over the age of 60 and all of whom had insomnia. Importantly, all of the participants “had no major depression or major health events in past year.”
The group was then split into two, with one group undergoing CBT-I (cognitive behavioural therapy for insomnia) while the other was given SET (sleep education therapy).
SET taught participants about sleep hygiene, characteristics of healthy sleep, sleep biology and how stress can impact sleep. CBT-I, meanwhile, is more in-depth and comprises five components: “cognitive therapy, stimulus control, sleep restriction, sleep hygiene, and relaxation.”
Sleep Foundation says CBT-I “focuses on exploring the connection between the way we think, the things we do, and how we sleep.” It theorises that insomnia can be a vicious cycle. Sleep Foundation gives an example of this, saying “prior experiences of insomnia may lead to worry about falling asleep. This worry may lead to spending excessive time in bed to try to force sleep.”
“Both worry and excessive time in bed can make falling and staying asleep more challenging. This can become a frustrating, nightly cycle that can be difficult to break.”
CBT-I works to break these habits. Stimulus control, for example, involves “getting people to get out of bed when they’re not able to sleep. Most people stay in bed, fretting about not falling asleep, which then turns the bed into a negative space,” Dr Irwin told CNN Health.
“Instead, people are taught to get up after 10 minutes of tossing and turning, do quiet, non-stimulating activities and not come back to bed until they are sleepy.”
The key difference in how the two therapy programs were delivered, is that the CBT-I group received in-person training with a trained therapist for the eight-week duration. The SET group simply had to take the information they were given and, according to Dr Irwin, “figure out how to use it without our help.”
With the CBT-I group, for example, a therapist worked with them to disrupt their “dysfunctional thoughts and beliefs about sleep.”
CNN Health cites Wendy Troxel, a senior behavioural scientist at RAND Corporation, but who was not involved in the study, as saying: “The benefit of this treatment approach is that it used the most evidence-based behavioural treatment for insomnia, CBT-I, which has been proven to be as effective, longer-lasting, and (have) fewer side effects than sleep medications – which can be particularly problematic in older adults.”
Following the eight week treatment period, participants were then monitored for a further three years (only 81 from the CBT-I group and 77 of the SET group agreed to the full 36 months of follow-up) and were asked every month about symptoms of depression.
The study concluded, “Those in the CBT-I group with sustained remission of insomnia disorder had an 82.6% decreased likelihood of depression compared with those in the SET group without sustained remission of insomnia disorder.”
As for the SET group, the study found “modest effects in improving and treating insomnia but they were not durable. They didn’t last.”
Wendy Troxel also added, “What is exciting about these findings is that they are among the first to demonstrate that treating insomnia with a behavioral strategy, not a pill, can prevent the development of depression in older adults.”
It should be noted, that this study doesn’t necessarily hold value for adults not considered to be part of the ‘older’ category, i.e. over the age of 60. However, Dr Irwin deliberately chose this demographic because: “Older adults with insomnia have a high risk of incident and recurrent depression. Depression prevention is urgently needed, and such efforts have been neglected for older adults.”
This means the results can’t necessarily deliver the same for adults under 60, although the study certainly does show that CBT-I can be an incredibly effective form of treatment for insomnia.
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