Background:Sleep difficulty is a major issue in recent times. The problem is more pronounced in metropolitan areas attributing to more stressful environment. Research indicates that there are different approaches to the management of insomnia and Cognitive behavior therapy (CBT) is one of the preferred treatment modalities.
Objective:To determine the symptoms related to primary insomnia and impact of cognitive behavior therapy.
Method:In the present study a group of 15 participants (Age range 20-30) who fulfilled the criteria of primary insomnia were administered 10 sessions based on cognitive behavior therapy. All the participants were voluntary and informed consent for the study was obtained. Frequency of sessions was once a week. Four components of CBT:Stimulus control instructions, sleep hygiene education, relaxation and cognitive therapy were implemented.
Results:Improvements in insomnia related variables such as sleep onset latency, number of nightly awakenings, total sleep time, wake up after sleep onset, sleep quality and sleep efficiency were measured before and after the intervention. The results indicate improvements in above mentioned insomnia related variables.
Ancoli-Israel S, Roth T.Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. I. Sleep 1999; 22, (2): 347-53.
Erman MK. Introduction to Chronic Insomnia: Classification and Prevalence. Primary Psychiatry 2007; 14, (5):27-31.
Kales A, Kales J.Evaluation and treatment of insomnia. Oxford University Press; New York: 1984.
Kales A, Soldatos CR, Kales JD. Review Sleep disorders: insomnia, sleepwalking, night terrors, nightmares, and enuresis. Annals of Internal Medicine 1987; 106, (4): 582- 92.
Ohayon MM. ZulleyJ.Correlates of global sleep dissatisfaction in the German population. Sleep 2001; 24, (7): 780-7.
Jernelöv S, Lekander M, Kaldo V. Efficacy of a behavioral self-help treatment with or without therapist guidance for co-morbid and primary insomnia -a randomized controlled trial, BMC Psychiatry 2012;12, (5): 1-23.
Spielman AJ. Assessment of insomnia. Clinical Psychology Review.1986; 6:11–26.
Spielman AJ, GlovinskyPB.The varied nature of insomnia. In: Hauri PJ, editor. Case studies in insomnia. Plenum Press; New York: 1991:1–15.
Bootzin RR. Stimulus control treatment for insomnia. Proceedings of American Psychological Association 1972; 7: 395-6.
Schutte-Rodin S, Broch L, Buysse D, Dorsey C,Sateia M. (2008).Clinical guideline for the evaluation and management of chronic insomnia in adults. Journal Clinical Sleep Medicine 2008; 4, (5):487-504.
Bootzin RR, Epstein D, Wood JM. Stimulus control instructions, In: P. Hauri (Ed.) Case studies in insomnia, New York, N Y: Plenum Press,1991:19-28
Spielman AJ, SaskinP,Thorpy MJ. Treatment of chronic insomnia by restriction of time in bed. Sleep 1987; 10: 45- 56.
Glovinsky PB, Spielman AJ. How did I get insomnia? In: Glovinsky PB, Spielman AJ. The Insomnia Answer: A Personalized Program for Identifying and Overcoming the Three Types of Insomnia. New York, NY: Berkley Publishing Group; 2006:51-82.
Morin CM. Insomnia: Psychological assessment and management, New York, The Guilford Press; 1983.
Harvey AG, Tang NKY, Browning L. Cognitive approaches to insomnia. Clinical Psychology Review 2005; 25: 593- 611.
Monroe L. Psychological and physiological difference between good and poor sleepers. Journal of Abnormal Psychology 1967; 72: 255-264.
Tang NKY Harvey AG. Effects of cognitive arousal and physiological arousal on sleep perception. Sleep 2004; 27, (1):69-78
Nicassio P, Bootzin RA. A comparison of progressive relaxation and autogenic training as treatment for insomnia. Journal of Abnormal Psychology, 1974; 83: 253- 60.
HauriPJ.Treating psychophysiological insomnia with biofeedback. Archives of General Psychiatry 1981; 752- 758.
Hauri PJ. Case studies in insomnia. New York: Plenum medical book 1991
Stepanski EJ,WyattJK.Use of sleep hygiene in the treatment of insomnia. Sleep Medicine Reviews, 2003; 7, (3): 215 225.
Coates TJ, Killen JD, George G, Manchini E, Silverman S, Thoresen C. Estimating sleep parameters: A multitraitmultimethod analysis. Journal of Consulting and Clinical Psychology1982:50, (3), 345-352.
American Sleep Disorder Association, International Classification of Sleep Disorders (ICSD); Diagnostic and Coding Manual. Rochester, MN: Author, 1997.
American Psychiatric Association,Diagnostic and statistical Manual of Mental Disorders-IVth Edition-Washington: DC. Author, 1994.
Ost LG. Applied Relaxation: description of a coping technique and review of controlled studies. Behaviour Research and Therapy 1987; 25: 397-410.
Verbeek IH, Konings GM, Aldenkamp AP, Declerck AC, Klip EC. Cognitive behavioral treatment in clinically referred chronic insomniacs: group versus individual treatment. Behaviour Sleep Medicine,2006;4(3):135-51.
Ga3usz ko-Wêgielnik M, Jakuszkowiak-Wojten K, Wiglusz MS, Cuba3a WJ, Landowski J. The efficacy of Cognitive-Behavioural Therapy (CBT) as related to sleep quality and hyperarousal level in the treatment of primary insomnia. Psychiatria Danubina 2012; 1: 51-55.
Wang MY, Wang SY, Tsai PS.Cognitivebehavioural therapy for primary insomnia: a systematic review. Journal of Advanced Nursing 2005; 50 (5): 553-564.
Morin CM, Culbert JP, SchwartzSM.Nonpharmacological interventions for insomnia: a meta-analysis of treatment efficacy. American Journal Psychiatry1994; 151 (8):1172- 80.
Edinger JD, Wohlgemuth, WK, Radtke, RA, Marsh GR, QuillianRE.Cognitive behavioral therapy for treatment of chronic primary insomnia: a randomized controlled trial. JAMA 2001; 2858 (14): 1856-164.
Van Houdenhove L, Buyse B, Gabriels L, Van Diest I, Van den Bergh O. (2010). Cognitive-behavioural therapy for primary insomnia: effectiveness in a clinical setting. Tijdschr Psychiatry2010; 52 (2): 79-88.