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The most common sleep disorder is insomnia, with 30-45% of adults complaining of insomnia in any given year.  Insomnia is diagnostically defined as difficulty initiating or maintaining sleep, or non-restorative sleep, for at least 1 month, which cause significant distress or impairment.  Insomnia is prevalent across all ages, but especially prominent in older adults.

Treatment

Changing thoughts:

Individuals who suffer from insomnia tend to underestimate the amount of time that they sleep and overestimate the negative consequences of their fatigue.

Many tend to worry and present some of the cognitive symptoms of anxiety or depression, like negative thoughts about their current situation or future. Strategies to cope with worry, anxiety or negative thinking in general are helpful, especially when the difficulty is initiating sleep.

The paradox is that the more one thinks “I must fall asleep now, otherwise…” the less the likelihood of falling asleep! One must learn to rest and enjoy being physically relaxed (e.g., with progressive muscle relaxation) and mentally still (e.g., with imagery or meditation).

Changing behaviors:

Good sleep hygiene is essential, as is the ability to relax.

Often times, these simple behavioral strategies combined with modifying unhelpful thoughts are enough to significantly improve one’s quality of sleep.

If not, sleep restriction is a technique that has been proven to be effective in treating insomnia. In brief, the insomniac figures out how many hours he/she currently sleeps per night (e.g., 5 hours). If that person needs to wake up at 7:00 am, he/she will begin going to bed at 1:40 am (to allow for 5 hours and 20 min) for a few nights, not before. He/she will then increase sleep time using 20-minute increments (i.e., going to bed at 1:20 am for a few nights; then 1:00 am, and so on). The rule of sleep restriction is that sleep is restricted until 85% of the time in bed is spent sleeping. At that point, one goes to bed 20 min earlier, each time.

Selected Book References

10 simple solutions to insomnia.
Dr. Christopher L. Drake (2008).
New Harbinger Publications. ISBN-13 978-0-89862-179-2.

The insomnia workbook: A comprehensive guide to getting the sleep you need.
Dr. Stephanie Silberman (2008).
New Harbinger Publications. ISBN-10 1572246359.


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