Forget sheep counting and drinking warm milk, an effective way to deal with chronic insomnia is cognitive-behavioral therapy, researchers have confirmed.
The authors of a new study say that although therapy is effective, it is not widely used because doctors have limited knowledge about it and patients who do not have access.
"There are many effective treatments that do not include medicines that should be offered through your primary care service. If it is not, it should be, "said Dr. Judith Davidson, co-author of a new CBT insomnia study at Queen's University in Ontario, Canada.
Chronic insomnia that makes it difficult for people to give up or stay asleep in at least three nights per week for three months or more is thought to affect about 10-15% of adults.The condition is associated with health problems, including depression, and difficulty in functioning and sometimes as a result of accidents
Sleep pills are not recommended for continued use use, and can have side effects as well as being a risk of addiction. Instead, the primary treatment for chronic insomnia is CBT, a program to change how an individual approaches and thinks about sleep. These include staying out of bed when
Writing in the British Journal of General Practice, Davidson and his colleagues reported that they had examined the results of 13 studies that had previously provided of MSW in insomnia through primary care. In some studies, participants also took medication to help them sleep.
The results show that TSG in insomnia is effective and has led to improvements in sleep that continued during follow-up many months later.
Looking at the results of four randomized control trials, with between 66 and 201 mixed-age participants, the team found that the participants fell asleep an average of nine to 30 minutes earlier after completing a CBC insomnia course and decreased between 22 and 36 minutes amount of time awake after bedtime. In contrast, those who were simply on the waiting list or undergoing treatment, as usual, only achieved up to four minutes of improvement in the time required to drop out, and a maximum of eight minutes of improvement in the time spent awake after bed
The team stated that four to eight CBT sessions seemed to be needed for improvement, with additional testing finding little benefit when only two CBT sessions were offered in insomnia.
Davidson stated that the new study supports the idea that THC in insomnia can and should be offered through GPs – the usual first port of patients – although, as in most studies, therapy itself can be delivered by others, such as nurses, social workers or other primary care services.  In the UK, she added, opportunities include increasing access through IAPT (improving access to psychological therapies) services, health visitors or even specialized applications and websites such as Sleepio, which is currently ava
. Helen Stokes-Lampard, chairman of the Royal College of Physicians, welcomed the study. "Insomnia-related CBT has been an option for first-line treatment for some time and we know that many patients have found it useful, so it's really positive that its efficacy has been shown by this study," she said. But, she added, access to MET through the NHS can be extremely difficult to implement in the community and is very variable across the country.
"This must be resolved, first, by the realization of the promise made in GPS for the advance of NPS England – for every GP practice in the country to have access to one of 3000 new mental health therapists by 2020-21. and by providing many additional psychologists are trained to provide formal CBT, "she said.