Got Insomnia? Change the Way You Think

Cognitive behavioral therapy may be effective for insomnia treatment

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) If insomnia is keeping you up at night, you may want to change how you think.

A new study from Rush University Medical Center found that cognitive behavioral therapy (CBT) may help patients with insomnia improve their sleep without taking medication.

“These findings provide empirical support for the recommendation of using CBT-I (cognitive behavioral therapy for insomnia) as the treatment of choice for comorbid insomnia disorders,” wrote lead study author Jason C. Ong, PhD, of Rush University Medical Center in Chicago, IL, and colleagues.

According to Dr. Ong and team, CBT-I is the most prominent non-medication treatment for insomnia disorders. However, less is known about the effectiveness of CBT-I on comorbid insomnia.

Comorbidity is the presence of one or more additional disorders that occur along with a primary disorder. Comorbid insomnia is insomnia that is the result of another disorder, such as mental illness. Insomnia is a sleep disorder in which there is an inability to fall asleep or to stay asleep as long as desired.

In CBT, the therapist and patient work together using homework and practice outside of therapeutic sessions.

While CBT acknowledges that there may be behaviors that cannot be controlled through rational thought — but rather come about because of conditioning from the environment or other external and internal stimuli — the goal of this therapy is to examine the relationship between thoughts and their effect on feelings and behaviors. Patients may be able to change self-destructive actions by changing their thoughts and beliefs.

Dr. Ong and team looked at 37 studies of more than 2,000 patients who received CBT treatment for insomnia. All patients also had psychiatric conditions, such as alcohol dependence, depression, post-traumatic stress disorder, chronic pain, cancer and fibromyalgia.

Dr. Ong and team found about twice as many patients who received CBT experienced insomnia relief compared to those who did not receive CBT. Patients with mental illness also showed symptom improvement related to their conditions.

In a related editorial, Michael A. Grandner, PhD, and Michael L. Perlis, PhD, of the University of Pennsylvania, wrote, “This meta-analysis demonstrates that CBT-I is an effective treatment for insomnia even in the context of potentially overshadowing medical and psychiatric conditions."

This study was published in the July issue of the journal JAMA Internal Medicine.

No funding sources were disclosed. Dr. Ong disclosed working as a consultant for Sleepio, Inc.


Review Date: 
July 2, 2015
Last Updated:
July 10, 2015