Running head: INSOMNIA 1

Insomnia

Erin N. Bosman

University of Wisconsin- Eau Claire; Harlaxton College

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Insomnia

Sleep Onset, Sleep Maintenance, Terminal Early Awakening, and Mixed

Sleep Problems are four types of sleep problems associated with insomnia. Insomnia is

correlated with a variety of problems such as distress in essential areas of daily life such

as occupational and social settings (Ritterband, L., & Clerkin, E., n.d.). Insomnia, which

is one of the most common sleep disorders, is characterized by inadequate sleep. It is not

necessarily a result from the hours of sleep an individual receives but rather a result from

the quality of sleep (Insomnia, 2015).

Insomnia can be divided into a variety of categories. In primary insomnia there is

no obvious cause of insomnia while in secondary insomnia there is insufficient sleep due

to disease, stress, or medicinal side effects. It can also be categorized by the length of

time the disorder occurs for and the effect it has on the sleep pattern. When a person

cannot sleep throughout the night, it is called sleep maintenance insomnia. Sleep onsets

insomnia occurs when the individual has difficulty falling asleep (Insomnia, n.d.).

Irritability, exhaustion, and disorientation can all occur as a symptom of insomnia.

In order to be diagnosed with insomnia, patients show a record of the symptoms they are

experiencing and representation of their difficulty sleeping. Often times, sleep history is

shown through a sleep diary. Individuals are evaluated from their medical history, as

well. Generally, the patient has a complaint about difficulty falling or staying asleep.

However, insomnia can occur as a symptom of other sleep disorders such as sleep apnea

or narcolepsy (Insomnia, 2015).

Following diagnosis, Insomnia can be addressed in a number of ways including

sleep restriction, sleeping pills, avoidance of psychoactive drugs, and cognitive

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behavioral therapy. Sleeping pills work for some individuals, but not for others. Due to

this and the fact that sleeping pills have side effects, they are often not recommended for

treatment. However due to their wide availability both over-the-counter and through

prescription, individuals will often attempt to cure their insomnia through sleeping pills

before trying other forms of treatment (Insomnia, n.d.).

Cognitive behavioral therapy for insomnia, CBT-I, helps to identify thoughts and

behaviors that result in sleep problems and replace them with thoughts and behaviors that

encourage sleep. Patients will be encouraged to use their cognitive abilities to recognize

and eliminate negative thoughts, and stressful thoughts. Often times, this is done through

keeping a sleep diary for a couple weeks.

For the behavioral therapy of CBT-I, individuals are encouraged to avoid

behaviors that may be inhibiting sleep and to develop good sleep habits. Some habits

recommended, dependent on apparent causes of the individual's insomnia, are sleep

restriction, stimulus control therapy, and biofeedback. Stimulus control therapy helps

remove the factors that have potentially conditioned the mind to resist sleep such as

through the process of setting a specific sleep schedule and avoiding taking naps. This

also is often done through having the patient avoid being in their bed, unless they are

sleepy. Sleep restriction causes partial sleep deprivation, to increase the individual’s

drowsiness for the following night. After sleep is improved, the individual's time spent

sleeping gradually becomes increased instead of restricted. Finally, biofeedback requires

the individual to observe biological signs throughout the day such as heart rate and

muscle tension. Then, the individual is told how to adjust these factors in order to both

improve and identify sleep patterns (Insomnia treatment: Cognitive behavioral therapy

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instead of sleeping pills, 2014). In addition, some of the techniques used in CBT-I, are

also used as individual treatments such as sleep restriction (Ritterband, L., & Clerkin, E.,

n.d.). Cognitive behavioral therapy for insomnia is often used for long-term treatment

while sleeping pills are used for short-term treatment. Sleeping pills can provide an

immediate solution when needed but are often avoided for long periods. In long- term

cases, other treatments are preferred such as CBT-I, chronotherapy, and relaxation

techniques (Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills,

2014).

Emotional, neurological, and cognitive factors can lead to insomnia. There are a

number of causes of insomnia including jet lag, sleep pattern disturbances, stress,

excitement, and medicinal side effects. It can result simply from one factor or a number

of factors but can be addressed and treated through a variety of treatments including

chronic behavioral therapy and sleeping pills, and can last for a few days or for a long-

term period. Treating Insomnia can be as simple as acquiring healthy habits of exercising

and having a set schedule, or it can require further treatment such as a sleep test.

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References

Insomnia. (2015, February 17). Retrieved April 11, 2015, from https://www.psychologytoday.com/conditions/insomnia

Insomnia. (n.d.). Retrieved April 11, 2015, from http://www.sleepdex.org/insomnia.htm

Insomnia treatment: Cognitive behavioral therapy instead of sleeping pills. (2014, February 11). Retrieved April 11, 2015, from http://www.mayoclinic.org/diseases-conditions/insomnia/in-depth/insomnia-treatment/art-20046677

Ritterband, L., & Clerkin, E. (n.d.). Insomnia. Retrieved April 11, 2015, from

https://www.div12.org/PsychologicalTreatments/disorders/insomnia_main.php