Therapeutic Approaches for Treating Insomnia - Sally W.
As many as 1 in 4 Americans experience insomnia each year, and about 6% go on to develop a chronic sleep disorder. Insomnia Disorder exists as its own diagnosis in the DSM V, and as a comorbid condition with other psychiatric diagnoses. An effective treatment plan for clients who have insomnia may include a combination of therapies, medications and lifestyle changes. Therapists should keep pace with the most advanced and recent therapeutic treatments for insomnia to help clients achieve better outcomes of care.
Overcoming Nightmares with Imagery Rehearsal Therapy
Persistent nightmares can disrupt sleep and cause a fear aversion to falling asleep at night. People who have PTSD and anxiety disorder frequently report experiencing vivid, frightening dreams that affect sleep quality. Nightmare Disorder is categorized as one of 11 sleep-wake disorders in the DSM V, however, it frequently contributes to and exacerbates Insomnia Disorder. Imagery Rehearsal Therapy is a form of CBT, which focuses on revisiting central themes in the narrative of recurring nightmares and imagining favorable alternative outcomes. The concept of exercising control over dream states is nothing new; reports of lucid dreaming date back to 1000 BCE and can occur spontaneously. IRT borrows elements from lucid dreaming, and is a controlled writing exercise, performed under the guidance of an experienced therapist. The process of IRT involves recording the content of a disturbing, recurring nightmare, then rewriting the story with a positive ending. Before falling asleep, the client reads their rewritten version of the dream as a guide to overcome the nightmare.
Conditioning Sleep with Stimulus Control Therapy
Stimulus Control Therapy focuses on behavioral changes for treating insomnia, and strengthening cues associated with bedtime and the bedroom. Conditioning a sleep response involves eliminating distracting stimuli from the sleep environment, and building associations of peace and restfulness. Guidelines for stimulus control therapy include spending no more than 20 minutes lying awake in bed, avoiding behaviors that reward staying awake, like late night eating and TV watching, skipping naps and maintaining consistent waking time. The bedroom should be a designated space for sleep and intimacy; activities like working, exercising and eating should take place outside the bedroom.
Mindfulness Practice and Meditation to Reduce Stress
Mindfulness meditation is designed to promote relaxation and bring non-judgmental awareness to the present moment. Engaging the senses and focusing on breathing patterns are common techniques in mindfulness practice. Stress and anxiety can be a root cause for insomnia and other sleep disorders; meditation as a coping mechanism for stress can make it easier to fall asleep. Introduce your clients to mindful meditation with guided exercises and encourage them to practice these techniques on their own before falling asleep.
Treating insomnia can be complex and often involves a team of specialists, including physicians, psychiatrists and therapists. Maintain communication with the rest of your client’s treatment team and adapt a dynamic approach to care. Fortunately, there are a variety of therapies available and new therapies emerging for successfully treating insomnia.
Picture from https://www.pexels.com
Overcoming Nightmares with Imagery Rehearsal Therapy
Persistent nightmares can disrupt sleep and cause a fear aversion to falling asleep at night. People who have PTSD and anxiety disorder frequently report experiencing vivid, frightening dreams that affect sleep quality. Nightmare Disorder is categorized as one of 11 sleep-wake disorders in the DSM V, however, it frequently contributes to and exacerbates Insomnia Disorder. Imagery Rehearsal Therapy is a form of CBT, which focuses on revisiting central themes in the narrative of recurring nightmares and imagining favorable alternative outcomes. The concept of exercising control over dream states is nothing new; reports of lucid dreaming date back to 1000 BCE and can occur spontaneously. IRT borrows elements from lucid dreaming, and is a controlled writing exercise, performed under the guidance of an experienced therapist. The process of IRT involves recording the content of a disturbing, recurring nightmare, then rewriting the story with a positive ending. Before falling asleep, the client reads their rewritten version of the dream as a guide to overcome the nightmare.
Conditioning Sleep with Stimulus Control Therapy
Stimulus Control Therapy focuses on behavioral changes for treating insomnia, and strengthening cues associated with bedtime and the bedroom. Conditioning a sleep response involves eliminating distracting stimuli from the sleep environment, and building associations of peace and restfulness. Guidelines for stimulus control therapy include spending no more than 20 minutes lying awake in bed, avoiding behaviors that reward staying awake, like late night eating and TV watching, skipping naps and maintaining consistent waking time. The bedroom should be a designated space for sleep and intimacy; activities like working, exercising and eating should take place outside the bedroom.
Mindfulness Practice and Meditation to Reduce Stress
Mindfulness meditation is designed to promote relaxation and bring non-judgmental awareness to the present moment. Engaging the senses and focusing on breathing patterns are common techniques in mindfulness practice. Stress and anxiety can be a root cause for insomnia and other sleep disorders; meditation as a coping mechanism for stress can make it easier to fall asleep. Introduce your clients to mindful meditation with guided exercises and encourage them to practice these techniques on their own before falling asleep.
Treating insomnia can be complex and often involves a team of specialists, including physicians, psychiatrists and therapists. Maintain communication with the rest of your client’s treatment team and adapt a dynamic approach to care. Fortunately, there are a variety of therapies available and new therapies emerging for successfully treating insomnia.
Picture from https://www.pexels.com
