AASM clinical guidelines for the evaluation and management of chronic insomnia consider behavioral treatment options, such as CBT-I, to be a recommended "first-line treatment option."
CBT-I is a combination of component behavioral therapy interventions, including therapeutic protocols derived from: (1) Stimulus Control Therapy; (2) Sleep Restriction Therapy; (3) Relaxation-Based Interventions; (4) Cognitive Strategies/Mindfullness Techniques; and (5) Sleep Hygiene Education. To learn more about these effective strategies, select: CBT-I
A very telling fact about the efficacy of CBT-I is to note its effectiveness for the treatment of insomnia in the context of other disorders. CBT-I is effective for the treatment of insomnia related to: depression
, and substance-abuse
issues. It is well-established that insomnia is closely associated with mental illnesses, both as a symptom and as a trigger. Its co-occurrance with major depression is 80%. In some studies, CBT-I is considered more effective than cognitive therapies addressed specifically to those psychiatric disorders. In addition to psychiatric disorders, CBT-I has also been shown to be effective for insomnia due to medical disorders, including chronic pain
and various medical conditions in the elderly population. Insomnia in older individuals is more likely to be comorbid with other medical conditions, medications, or substances. If insomnia is comorbid with OSA or any other condition, CBT-I and insomnia treatment in general are no longer considered secondary treatment priorities but can be applied in tandem
with other treatment modalities because contraindications do not arise with CBT-I, except for some advanced illnesses.