Cooling Cap Could Provide Insomnia Relief

There is no easy cure for insomnia. Sleeping pills appear to be a quick fix, but the potential for psychological attachment and rebound insomnia make medication for insomnia a solution for short-term problems only. Alternatively, you can seek cognitive behavioral therapy to help eliminate the harmful thoughts and bad habits that promote extended periods of insomnia. This solution is very effective but also time-consuming and requires effort and dedication.

New research presented at SLEEP 2011, the 25th Anniversary Meeting of the Associated Professional Sleep Societies LLC (APSS), suggests another treatment choice for insomnia may be on the horizon. The potential treatment would use a cooling cap that would lower your brain temperature to help you fall asleep.

Normally, a reduction in brain metabolism occurs as you fall asleep. However, during insomnia, the brain metabolism increases, keeping you awake. The cap helps reduce metabolic activity by cooling the front half of the brain.

The study involved 24 people. Half of the participants had insomnia. Each was subjected to several overnight sleep studies while wearing the cooling cap. The settings for the cooling cap differed each night, ranging from maximum amounts of water cooling to not wearing the cap at all.

Results show patients who wore the cooling cap set to its maximum level slept nearly as well as the subjects who didn’t have insomnia. These findings suggest the device could be a new promising therapy for insomnia sometime in the future. The treatment is still a long ways off; more studies will need to be conducted before the device can hit the marketplace.

Study Links Sleeping Pills to Mortality

Sleeping pills lengthen your slumber and may shorten your life, a Canadian report claims. The 12-year study linked hypnotic class sleep drugs and anti-anxiety medications with long-term mortality.

Consumption of sleeping pills or anxiety relieving medications was associated with a 36 percent higher death risk, the study concluded. Respondents to a large Canadian National Survey who said they used the medications at least once a month had a mortality rate of 15.7 percent. Those who said did not use the medications had a rate of 10.5 percent. The results were controlled to person risk factors like tobacco use, depression and physical health.

The study offers no clear explanation of the findings. The results bare resemblance to a study published in the September issue of the journal SLEEP that investigated a possible link between insomnia and long-term death risk. It reported five times as many middle-aged male insomnia patients died over the 14-year study length compared with healthy subjects.

Could the elevated mortality rates associated with sleeping pills be due to long-term insomnia? It is not a stretch to conclude a many of the people who regularly use sleeping pills over an extended period of time also have long-term insomnia.

Dr. Geneviève Belleville, the lead author of the sleeping pill study, offers an alternate explanation. Dr. Belleville speculates the sleeping pills and anti-anxiety medications may cause accidents and promote suicides.

Sleeping pills and anxiolytics impact reaction time, alertness and coordination. Under these conditions, the risk of injury from a fall or an automotive accident increases.

A review shows sleeping drugs may increase the risk of suicide as many as seven times over. Central nervous system inhibitors found in the medications may alter a person’s judgment, making some people more likely to carry out suicidal ideations.

The AASM reports hypnotic class drugs are safe and effect short-term solutions to insomnia when used as directed. Go to bed immediately after taking sleep medications and avoid physical activity, driving, or operating heavy machinery. Never take more than the recommended dose, for risk of serious complications.

Dr. Belleville recommends insomnia patients consider the alternative of cognitive behavioral therapy, the most effective solution to long-term insomnia. The approach helps you change actions or thoughts that hurt your ability to sleep and promote a healthy pattern of sleep.

Image by Zach Armstrong

CPAP for Sleep Apnea Obstructed by Insomnia

A double dose of sleep disorders can disrupt the first option of treatment. Patients who complain of insomnia more often give up on Continuous Positive Airway Treatment (CPAP), researchers at Johns Hopkins University report.

CPAP involves wearing a sealed mask while you sleep. A tube connected to the mask gently blows air into the back of your throat. The sensation may feel unnatural at first. Some patients give up on treatment before they become comfortable with CPAP.

This phenomenon appears to be worse among insomnia patients. People with insomnia may fixate on environmental distractions or sensations like muscle soreness or the urge to urinate while lying awake restlessly. The foreign-feeling CPAP machine might be a big hang-up for this type of insomnia patient.

The study looked at 232 patients’ medical charts at Johns Hopkins Hospital Sleep Disorders Center. Each subject was newly diagnosed with obstructive sleep apnea and prescribed CPAP. Questionnaire data shows 37 percent of participants had at least one form of primary insomnia.

Electronic monitoring data from CPAP shows patients who complained of sleep maintenance insomnia used their device for the fewest overall minutes.

The authors of the study believe more patients may stick with CPAP if their insomnia is first addressed. Cognitive-behavioral therapy is an effective long-term solution to insomnia and may also help CPAP adherence.

The two sleep disorders often coexist and have similar symptoms. A previous study shows 39 to 58 percent of OSA patients have insomnia. Insomnia and sleep apnea can reduce your quality of life, destroy your work productivity and increase your risk of getting in an auto accident.

“Good Morning America” Dr.: cognitive behavioral therapy better fix for insomnia than sleeping pills

This morning a segment on ABC’s “Good Morning America” explained how cognitive behavioral therapy works and how it helps patients with insomnia.

The first in a series of stories titled “Help Me Fix It”, Dr. Richard Besser emphasized you don’t need pills to get your sleep back on track.



The AASM recognizes cognitive behavioral therapy as the treatment of choice for primary insomnia. Sleeping medications such as Ambien or Lunesta are viewed as an effective temporary solution for short-term insomnia.

CBS 2’s "Sleep Wreckers" are a few of the common-sense insomnia culprits

On day 2 of WCBS New York City’s “Sleep Week,” health reporter introduced viewers to their so-called “Sleep Wreckers.”

Most elements in their list should be familiar for regular blog readers.

- Pets in bed
-Alcohol before bedtime
-Supplements like B6, B12 or Ginseng in the evening
-Sleep disorders like sleep apnea or restless leg syndrome
-Pain or discomfort while sleeping
-Stress

The report only scratches the surface for behaviors that contribute to sleeplessness. Some are more obvious than others.

-Caffeine after lunch
-Eating before bed
-Exposure to bright light before bedtime
-Heavy evening exercise
-Nicotine before bedtime
-Lengthy naps
-Irregular sleeping patterns
-Using your bed for activities other than sleep
-Uncomfortable sleeping environment

The author of the WCBS article recommends prescription sleep drugs for treating short-term insomnia. The AASM recognizes medications such as Ambien or Lunesta as an effective temporary fix. However, we first suggest improving sleep hygiene and eliminating these “Sleep Wreckers.” Some people may need the assistance of a sleep professional. Cognitive Behavioral Therapy is the treatment of choice for insomnia. Patients work with behavioral sleep experts to change the thoughts and actions that contributed to difficulty sleeping.

Learn more about Cognitive Behavioral Therapy on Sleepeducation.com.

Chronic Pain: Cognitive Behavioral Therapy Improves Sleep

A new study found that cognitive behavioral therapy (CBT) can significantly improve sleep for people with chronic neck or back pain.

Many people living with chronic pain have poor sleep hygiene. Common mistakes include sleeping when they are not tired, sleeping in places other than the bedroom and watching TV in bed. These habits may lead to insomnia.

People taking medicine for their pain may be unwilling or unable to use sleep aids to treat their sleep problems. CBT provides a safe and effective alternative.

The study involved 28 people who experience chronic pain. Participants received eight weeks of therapy from a trained nurse therapist.

Therapy sessions established a set number of hours in bed, focused on negative thoughts about sleep and addressed unhealthy sleep behavior. Sleep diaries were used to track sleep. Pain and mood were measured throughout the study. Patients were followed for six months after treatment.

Patients who are interested in CBT but have limited access to face-to-face sessions can receive treatment online. Last year the Sleep Education Blog reported that online CBT programs have the potential to provide long-lasting effects for people who suffer from chronic insomnia.

The AASM recommends CBT as an effective treatment for chronic insomnia in adults. Consult a board-certified sleep expert at an AASM-accredited sleep center if you are suffering from an ongoing sleep problem.

How Does Yoga Help You Sleep?

Yesterday the Globe and Mail examined how yoga helps you sleep.

Harvard assistant professor Sat Bir Khalsa, PhD, told the Globe and Mail that yoga helps reduce the stress that can hinder sleep.

“With time and practice, the stress system begins to quiet down,” he said.

What changes occur in the body during yoga? The NCCAM reports that it is unclear. But there is growing evidence that yoga enhances stress-coping mechanisms.

One study by Khalsa used yoga to help people with chronic insomnia. They had one in-person training session. Then they practiced yoga on their own for eight weeks. They also had brief follow-ups by phone and in person.

Results show that sleep improved in 20 people who completed the study. They fell asleep faster and slept longer.

A review he published found that most yoga research has been conducted and published in India. But researchers in the U.S. and England are starting to conduct more studies.

A yoga instructor also explained to the Globe and Mail that bedtime yoga is easy and convenient. She practices yoga techniques while in bed in her pajamas.

“It’s not a magic button,” she said. “But I know that I’m not just lying down there and tossing and turning – I’m restoring my body.”

The article also described the iRest program. It involves a form of yoga called “yoga nidra.” It reduces stress and promotes deep relaxation.

In 2006 the U.S. Department of Defense began testing the iRest protocol. It has been used to help soldiers who have PTSD.

Learn more about sleep and yoga. Read more about insomnia.

There are a variety of cognitive and behavioral methods that are effective for treating insomnia. Learn more about cognitive behavioral therapy on SleepEducation.com.

Image courtesy of the National Institute on Aging

Can Yoga Help You Sleep Better?

The show eightWest on WOOD TV8 in Grand Rapids, Mich., did a feature on “Yoga for Better Sleep.” The five-minute segment shows some yoga moves that can help you relax for bedtime.



So can yoga really help you sleep better?

Last year the Sleep Education Blog reported on a small study from Northwestern University. It involved 11 adults with chronic primary insomnia. Sleep improved for those who practiced yoga and meditation for two months.

A recent study from India evaluated “cyclic meditation.” This technique combines yoga postures with periods of lying down on your back to rest.

Thirty men practiced cyclic meditation twice during the same day. On another day they had two sessions of rest without the yoga postures.

The study found that the men had more deep, slow-wave sleep after cyclic meditation. They also had fewer awakenings. And they felt that their sleep was more refreshing.

There are a variety of cognitive and behavioral methods that are effective for treating insomnia. Learn more about cognitive behavioral therapy on SleepEducation.com.

Changing Nightmares: Imagery Rehearsal Therapy

“Your Health” columnist Kim Painter reports in USA Today that imagery rehearsal therapy is helping some people change their nightmares.

This method is just one form of cognitive behavioral therapy. A variety of CBT techniques have been used to reduce nightmare frequency.

One method is to record your nightmares in a diary. Relaxation exercises also may be helpful. Exposure techniques involve “reliving” a nightmare in your imagination during the daytime.

Cognitive-restructuring techniques involve changing a nightmare. One technique is lucid dreaming treatment; you change the nightmare as it occurs during sleep.

Imagery rehearsal therapy involves changing the nightmare while awake; you “rehearse” the new version in your mind during the day.

The first step is to write down a recent nightmare. Then you change the nightmare. Usually you change it to a more positive version.

You write down this new version. Then you rehearse it in your mind daily; you imagine the imagery of the changed nightmare.

In 2008 a review in the Journal of Clinical Sleep Medicine noted that CBT has become the treatment of choice for nightmares. It reported that imagery rehearsal therapy and exposure are effective at reducing nightmares; the methods also reduce other sleep complaints and mental distress.

The authors noted that the drug prazosin also may be effective at reducing nightmares. But it appears that treatment requires ongoing use of the drug; nightmares may return after drug withdrawal.

One of the review’s co-authors was sleep specialist Dr. Barry Krakow. He is founder of the Maimonides International Nightmare Treatment Center in Albuquerque, N.M.

In 1992 Krakow and colleagues at the University of New Mexico published a study of imagery rehearsal therapy in the journal Sleep. They found that the therapy reduced nightmare frequency by 72 percent.

Nightmare rehearsal was first reported as an effective treatment option in a 1978 case study. The method was adapted into an imagery rehearsal technique at the University of New Mexico; the first case studies were reported in 1991.

In June the Sleep Education Blog reported that imagery rehearsal therapy also can be helpful for children with nightmares. Learn more about dreams and nightmares on SleepEducation.com. Get help for nightmare disorder at an AASM-accredited sleep center near you.

Image by Cornelia Kopp

Biofeedback to Treat Insomnia

A recent article from Health magazine describes the use of “biofeedback” to treat insomnia.

What’s biofeedback? It’s a form of therapy that gives you visual or auditory feedback for certain body signals.

Cues may give you details about your heart rate, blood pressure, breathing or body temperature. Then you learn to control the body in a way that promotes sleep.

Author Leslie Goldman describes how for eight years she struggled with sleep. Then she gave biofeedback a try.

“The change has been dramatic,” she writes. “After nearly a decade of sleeping for no longer than two hours at a time, I can sleep for four hours straight and doze off again after I wake up.”

The AASM recommends biofeedback as an effective treatment for chronic insomnia.

Often biofeedback will be combined with other treatment methods. This is called cognitive behavioral therapy, or CBT.

CBT is a safe and effective treatment option for people who are struggling with ongoing insomnia. It uses a variety of methods to help you develop positive attitudes and habits that promote a healthy pattern of sleep.

Learn more about how CBT for insomnia is safe and effective. Get help for insomnia at an AASM-accredited sleep disorders center near you.

Civilian Life is Interrupted by PTSD and Sleep Disorders for Many Soldiers Returning from Iraq

A new study finds high rates of disturbed sleep among current and former military personnel who served in Afghanistan during Operation Enduring Freedom or Iraq during Operation Iraqi Freedom.

Sleep problems were considerably more common and severe among those with post-traumatic stress disorder (PTSD), reports Military.com. PTSD is an anxiety syndrome that occurs after a traumatic event, such as combat or military exposure. Symptoms typically improve after three months of treatment, but for some people the problem continues for the rest of their lives.

Data from the Pentagon suggests that up to 20 percent of returning Iraq war veterans suffer from PTSD. Records from the Department of Veterans Affairs show that nearly 76,000 veterans of the current wars were diagnosed with PTSD between 2002 and mid-2008.

According to the AASM, most people with PTSD report having disturbed sleep, and suffer from severe nightmares in which they relive the traumatic event. Severe cases of PTSD may be treated with cognitive behavioral therapy and medications to improve sleep.

Learn more about PTSD on SleepEducation.com.

Image courtesy of the U.S. Army.

Chemotherapy Causes Sleep Problems in Breast Cancer Patients

A study published this week in the journal Sleep shows that chemotherapy for Breast Cancer, a disease with which approximately 210,000 women are diagnosed each year, impairs sleep-wake cycles in patients. Sleep disturbances can negatively affect treatment and increase risks for other health and mental problems.

Results indicate that chemotherapy patients switched from low to high activity about 30 minutes later in the day and decreased their level of activity about 50 minutes earlier at night during their first round of chemotherapy, suggesting that their days were shorter.

The study involved 95 women with an average age of 51 years, who were scheduled to receive chemotherapy for stage I-III Breast Cancer. Of the participants, 75 percent were Caucasian, 69 percent were married, 77 percent had at least some college education, and 73 percent reported an annual income of more than $30,000.

“Our biological clock, or (24-hour cycles) help keep our bodies in sync with the environment. During chemotherapy, our biological clock, or circadian rhythm gets out of sync, especially after the first cycle of treatment. The clock seems to regulate itself after only one cycle, but with repeated administration of chemotherapy, it becomes more difficult for the biological clock to readjust,” study author Dr. Sonia Ancoli-Israel told the AASM.

Sleep disturbances are common in cancer patients, with 30 percent to 50 percent reporting symptoms of insomnia. The authors state that it is important to screen more routinely for sleep disruptions in Breast Cancer patients undergoing chemotherapy and to offer treatment, such as cognitive behavioral therapy or bright light therapy, to prevent sleep disturbances from becoming chronic.

According to the AASM, studies show that cognitive behavioral therapy helps both women with breast cancer and breast-cancer survivors. It helps patients develop habits that promote healthy sleep patterns by changing actions and thoughts that hurt their ability to sleep well.

Osteoarthritis: CBT for Insomnia Improves Sleep & Pain

A study in the Aug. 15 issue of the Journal of Clinical Sleep Medicine involved 51 older adults with osteoarthritis and insomnia.

Twenty-three people received cognitive behavioral therapy for insomnia; they had an average age of 69 years. Each of the eight weekly CBT sessions lasted two hours; class sizes ranged from four to eight people.

CBT uses a variety of methods to help you develop positive attitudes and habits that promote a healthy pattern of sleep. One common technique is relaxation training.

Results show that CBT improved self-reported sleep quality in people with osteoarthritis and insomnia. After treatment they fell asleep faster; they also spent less time awake during the night. Overall their sleep was much more efficient.

CBT also had a long-term effect; they were still sleeping better at a one-year follow-up. They also were sleeping more than 30 minutes longer each night.

Another finding was that people with osteoarthritis reported less pain after CBT for insomnia. The pain reduction was strongest during the month after the CBT sessions ended; a mild reduction in pain was reported one year later.

“Improvement of sleep may lead to improvement in co-existing medical or psychiatric illnesses, such as osteoarthritis or depression,” lead author Michael V. Vitiello, PhD, told the AASM. “These additional benefits can be seen in the long term.”

The NIAMS reports that osteoarthritis is the most common type of arthritis. It involves the loss of cartilage around the joints. It affects an estimated 27 million people in the U.S.; most often it occurs in older adults.

Last week the Sleep Education Blog reported that studies have linked sleep and pain sensitivity. Treatments that improve sleep quantity and quality may make a person less sensitive to pain.

This can be helpful for people with a chronic pain condition. But it is unlikely to solve the problem of pain for them.

“Pain may be an outcome that has only a limited range to change,” wrote Patricia L. Haynes, PhD, in a commentary that followed the study. “The pain is not going to go away.”

Learn more about insomnia due to medical condition on SleepEducation.com.

Cognitive Behavioral Therapy for Insomnia: Safe & Effective

A recent article in the Louisville Courier-Journal reminded readers that medications aren’t the only insomnia treatment. Cognitive behavioral therapy is a safe and effective treatment option for people who are struggling with ongoing insomnia.

CBT uses a variety of methods to help you develop positive attitudes and habits that promote a healthy pattern of sleep. One common technique is relaxation training.

“We teach people how to sleep again,” sleep specialist Ryan Wetzler told the Courier-Journal. He has a doctorate in psychology and is certified by the AASM in behavioral sleep medicine. “We want to just figure out why somebody is not sleeping and get them sleeping again as soon as possible.”

Wetzler recently led a study of 115 people with insomnia; he presented a study abstract in June at SLEEP 2009. Results show that CBT is effective in a “real world” clinical setting.

“We saw complete remission of their primary symptom in 50-60 percent of people,” said Wetzler.

People who had trouble going to sleep benefited from CBT; they were able to fall asleep 58 minutes faster after at least two treatment sessions. CBT also helped people who had trouble staying asleep; the time they were awake during the night decreased by 30 minutes.

Sixty-four people completed five or more CBT sessions. They woke up fewer times during the night; their total sleep time also increased.

In July the Sleep Education Blog reported that online CBT programs also may be effective. They make the treatment available to anyone with Internet access. But some people may fail to follow through with online treatment.

Get help for insomnia at an AASM-accredited sleep disorders center near you.

Image by Justin Silles

Sleep Music: A Jewel “Lullaby” & Relaxation CDs

The new 15-track CD “Lullaby” from three-time Grammy nominee Jewel is an acoustic ode to sleep.

Released in May, the self-produced release features 10 original songs such as “Sweet Dreams.” The other songs are classic lullabies such as “Twinkle, Twinkle” and “Brahms’ Lullaby.”

“This isn’t just a ‘kids’ album, it’s really a mood album – perfect to relax to at the end of a long day,” Jewel said in a prepared statement. “It will soothe and lull children, but was also written and sung for adults to enjoy and unwind with.”

Currently the CD is the top-selling compilation of lullabies on Amazon.com.

But it’s not just parents who are hoping that music can promote a good night of sleep. Two of the top five recordings on Amazon’s best-selling “Self-Help” list also are sleep related.

At #2 is “Delta Sleep System” by Dr. Jeffrey Thompson. Released in 1999, it seeks to promote the delta waves that increase during deep, slow-wave sleep. It combines music, nature sounds and embedded “pulses” of sound.

At #5 is “Sleep Soundly” by Steven Halpern. Released in 1994, it is a collection of New Age music from the 1980s. The songs combine piano-based “sonic textures” with “subliminal, sleep-encouraging affirmations.”

In May the Sleep Education Blog reported that there is some research to support using music to sleep better. The U.S. Department of Homeland Security is even studying the use of “brain music.” The goal is to help emergency responders sleep well when they end a stressful shift.

Relaxation training is one method of cognitive behavioral therapy for insomnia. Learn more about CBT on SleepEducation.com.

Image courtesy of Fisher-Price

Online CBT for Insomnia: Using the Internet to Get Some “SHUTi”

Research continues to show that online cognitive behavioral therapy may be an effective treatment for adults with ongoing insomnia.

A new study involved 44 people with an average age of 45 years. They had struggled with insomnia for an average of more than 10 years; most of the participants were women.

Half of the group was put on a wait list as a control; the other half completed a nine-week, online CBT program called “Sleep Healthy Using the Internet” – or SHUTi.

Results show that insomnia severity improved significantly for the Internet group; there was only a slight improvement for the control group. Members of the treatment group spent less time awake during the night. Their sleep also was more efficient; a higher percentage of their total time in bed was spent sleeping.

The online treatment also had a long-lasting effect; members of the Internet group were still sleeping better at a six-month follow-up.

SHUTi was developed at the University of Virginia Health System. The lead author of the new study was SHUTi creator Lee Ritterband, PhD. He also is the co-founder of the International Society for Research on Internet Interventions.

The AP reports that SHUTi is highly interactive; it uses stories, quizzes and games to teach healthy sleep habits. It also gives personalized advice based on a completed sleep diary.

The content is divided into core units that focus on specific methods for improving sleep. These include sleep restriction, stimulus control, sleep hygiene, cognitive restructuring and relapse prevention.

These methods are based on traditional, face-to-face CBT. The AASM recommends CBT as an effective treatment for chronic insomnia in adults.

In June the Sleep Education Blog reported on a study of another online CBT program. The five-week program helped most people in the treatment group; 81 percent reported at least mild improvement in their sleep.

Contact an AASM-accredited sleep center near you for help with insomnia.

Treating Insomnia with Yoga & Meditation

A study being presented today at SLEEP 2009 in Seattle, Wash., reports that an effective treatment for insomnia may be “Kriya Yoga.” This is a type of meditation that combines different yoga techniques.

The small pilot study involved 11 adults with chronic primary insomnia. They were between the ages of 25 and 45 years. Seven of them practiced Kriya Yoga for two months; four of them only received health education that included tips to improve their sleep hygiene.

Results show that there were significant improvements for members of the meditation group. They fell asleep faster and slept longer. They spent less time awake in bed during the night. Their sleep efficiency and sleep quality improved. They even had fewer symptoms of depression. Only total sleep time improved for the control group.

“Results of the study show that teaching deep relaxation techniques during the daytime can help improve sleep at night,” study author Ramadevi Gourineni told the AASM.

Learn about cognitive behavioral therapy for insomnia on SleepEducation.com.

Internet Intervention: Online Cognitive Behavioral Therapy for Insomnia

Research has shown that cognitive behavioral therapy is an effective treatment option for chronic insomnia. But can online CBT help you sleep better?

Some health insurers think so. In November the L.A. Times reported that online CBT for insomnia is covered by some insurance providers.

Now a new study published today in the journal Sleep adds to the evidence supporting online CBT for insomnia. Results show that a five-week, online CBT program helped most people in the treatment group; 81 percent reported at least mild improvement in their sleep.

A TIME article reported today that there are many positive aspects of online CBT. It can be available to anyone with Internet access. Users also may be able to proceed at their own pace and repeat material as needed.

But some people may fail to follow through with an online treatment program. In the current study there was a 33-percent drop-out rate.

A few previous studies of online CBT for insomnia provided mixed results. An abstract presented at SLEEP 2008 involved a six-week program. Results show that participants increased their average, nightly total sleep time by 80 minutes.

A 2008 study from Japan evaluated a two-week program. Sleep quality and sleep-related behaviors improved significantly. After treatment participants were able to fall asleep about eight minutes faster. But there was little change in total sleep time.

A 2004 study from Sweden used a five-week program. Sleep improved in both the treatment group and the control group.

So what’s the bottom line? Online CBT programs have great potential for people who suffer from chronic insomnia. But they may need to be fine-tuned to maximize their effectiveness.

Go to SleepEducation.com to get more details about online CBT for insomnia.

Contact an AASM-accredited sleep center near you for help with insomnia.

Combining Cognitive Behavioral Therapy with a Medication to Treat Insomnia

For people with insomnia, taking a medication can help break the cycle of sleepless nights. And cognitive behavioral therapy can lead to long-lasting improvements with little risk of side effects. But what happens when you combine these two treatments?

A new study helps to answer this question. The results were published today in The Journal of the American Medical Association.

The study involved 160 adults with chronic insomnia. For six weeks they were treated with either CBT or CBT combined with 10 mg of zolpidem at bedtime. Zolpidem is the generic name for Ambien.

Then the study continued for six months. Some of the people treated with only CBT attended monthly treatment sessions; others had no further treatment. Some participants in the combined treatment group continued with CBT and zolpidem; others continued only with CBT.

Results show that for the first six weeks, both CBT and CBT combined with zolpidem reduced insomnia symptoms. About 60 percent of participants in each treatment group slept better. Treatment eliminated insomnia symptoms in 39 percent of the CBT group and 44 percent of the CBT with zolpidem group. The combined treatment also produced a larger increase in total sleep time.

What was the best long-term treatment? CBT with zolpidem for the first six weeks, followed by ongoing CBT without medication. This method eliminated insomnia symptoms in 68 percent of participants.

The study suggests that a combined approach may maximize the strengths of both common insomnia treatments.

You should never take a sleeping pill without first getting approval from your doctor. A sleep specialist at an AASM-accredited sleep center can develop a treatment plan for insomnia that is best for you.

“Brain Music”: Sleeping Better by Listening to the Music of Your Mind

According to the U.S. Department of Homeland Security, your brain has its own music soundtrack. And this “brain music” just might help you sleep better.

The DHS wants to help emergency responders sleep well when they end a stressful shift. So it is studying the use of “brain music.”

How is this music recorded? The Loudoun Times-Mirror in Virginia reports that you wear a skullcap that contains EEG sensors. For about five minutes these sensors record your brain waves.

Then a computer analyzes the data. It finds the rhythm of your brain waves and transforms the unique pattern into two musical compositions. One has a fast tempo to boost alertness; the other has a slow tempo to promote relaxation.

You listen to this music at scheduled times according to your needs. It is believed that this musical feedback triggers a natural response in your brain. The fast-paced music gives you a burst of productivity and energy; the relaxing music helps you recover from a stressful situation. You can listen to a brain music sample provided by the DHS.

Does it work? It is still being tested as part of the DHS Readiness Optimization Program. But the idea has intriguing possibilities.

There is some support for using music to sleep better. A small study in 2008 showed that music therapy may reduce insomnia symptoms in older adults. Music relaxation improved their sleep and reduced their anxiety.
Another study of young adults between 19 and 28 years of age found similar results. They listened to relaxing classical music for 45 minutes at bedtime. This improved their sleep quality and reduced depressive symptoms.

There also is strong evidence that supports the use of cognitive behavioral therapy to treat insomnia. CBT is effective and has long-lasting results. Treatment methods include relaxation training and biofeedback.

“Brain music” therapy combines some elements of both music therapy and CBT. Should it be included as one of the techniques used in CBT? The evidence is not in yet.

But a sleep specialist at an AASM-accredited sleep center can determine which insomnia treatment is best for you.

Image by Michael Summers