Insomnia treated with single therapy session

A one-hour therapy session has been shown to resolve acute insomnia in 73% of cases.

In the first study to attempt to treat insomnia in the acute phase, researchers from Northumbria University found that almost three quarters of subjects saw improvements in the quality of their sleep within three months of a 60-minute cognitive behavioural therapy session. The researchers say their findings, which have been published in the journal Sleep, are important because people transitioning from acute to chronic insomnia are particularly vulnerable to depression. Around one-third of the population experience insomnia, with 10% suffering from an insomnia disorder.

The 40 study participants, who reported suffering from insomnia for less than three months and were not taking hypnotics, were divided into two groups. The treatment group received a one-hour, one-to-one cognitive behavioural therapy (CBT) session delivered by study leader Jason Ellis, and a self-help pamphlet to read at home, while the control group received no support. All participants used sleep diaries to record the quality and duration of their sleep for seven days before treatment, and completed the Insomnia Severity Index, which measures the nature, severity and impact of insomnia.

The therapy session covered sleep education and individual differences in ‘sleep need’ at different times of life. It also covered the principle of sleep restriction, which encourages individuals to spend only the time in bed required for sleep. Using their sleep diaries, each individual was prescribed a time to go to bed and a time to rise to improve their sleep efficiency.

The self-help pamphlet used a “3-D” message, which represented three actions for the individual to recognise and act upon the symptoms of insomnia: ‘Detect’ — how to record their sleep diary: ‘Detach’ — how to control the stimulus that could lead to disrupted sleep; and ‘Distract’ — instructions on how to use cognitive control and imagery to distract the mind.

Within a month of their therapy session, 60% of participants reported improvements to their sleep quality. This had increased to 73% within three months. Only 15% of those in the control group reported improved sleep.

Ellis said: “Despite considerable evidence supporting the use of cognitive behavioural therapy for chronic insomnia, it remained untested for acute insomnia until this study. Chronic insomnia is a highly prevalent and largely unrelenting condition, so anything we can do to stop acute insomnia developing to the chronic stage will be of real benefit.”

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Citation
The Pharmaceutical Journal, February 2016;Online:DOI:10.1211/PJ.2016.20068910