Insomnia & dCBT: Well Beyond Pills and Way More Than Just Sleep

by Bill White | Oct 3, 2018

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mbien, trazodone, Lunesta, temazepam, Advil PM, Belsomra, Seroquel. Hypnotics, antidepressants, benzos, OTCs, antipsychotics. Know what? Insomnia relief goes well beyond pills, and it’s about way more than sleep. Let’s address quality of life as we learn about dCBT…

‘These findings indicate that dCBT improves both daytime and nighttime aspects of insomnia, lending further weight to the clinical guideline recommendation of CBT as the treatment of choice for insomnia.’

Here we go with the sleep thing again. Last week it was sleep apnea and this go-round, insomnia. But it’s really that important. After all, our bodies, especially our brains, are intended to physically restore – heal – during sleep, removing built-up metabolic wastes. So without quality sleep, life can become rugged.

Perhaps like you, I’m not the best sleeper in the world. Wouldn’t call it insomnia, I just don’t sleep soundly. And feeling refreshed when it’s time to “rise and shine” doesn’t come easy.

Now, I have a supply of Belsomra samples in my bathroom closet, which remain untouched. Fact is, I just don’t want to go there. I mean, there has to be a way to handle the sleep issue, as well as opening the door to grabbing more out of life.

Yes?

Well, it seems a research team from the University of Oxford and Northwestern Medicine agree. Their study, “Effect of Digital Cognitive Behavioral Therapy for Insomnia on Health, Psychological Well-being, and Sleep-Related Quality of Life: A Randomized Clinical Trial,” was just published in JAMA Psychiatry.

Let’s Roll!

Okay, the team approached their work within the context of this question: “Can digital cognitive behavioral therapy (dCBT) for insomnia improve functional health, psychological well-being, and sleep-related quality of life, and does a reduction in insomnia symptoms mediate these potential improvements?”

So the team kicks things off by emphasizing that CBT is the recommended intervention for insomnia. BTW, did you know that? In detail, the behavioral component addresses stimulus control, sleep restriction, and relaxation. The cognitive piece involves managing sleep-related worries, racing mind, and intrusive thoughts. And an educational portion teaches sleep hygiene.

Bottom-line: meta-analyses say it works.

Specifically dCBT

How to treat insomnia Speaking of meta-analyses, the team inform us that they indicate dCBT – delivered using automated web platforms or mobile apps – works, as well.

And here’s where things get especially interesting…

Sure, CBT and dCBT have significant impact on nighttime insomnia symptoms. But often not considered, daytime symptoms are a significant portion of insomnia disorder. So improving things such as functional health, psychological well-being, and quality of life are likely crucial in the successful treatment of insomnia.

Told you it was way more than sleep.

dCBT to the Test & Results

So the team gathered some 1700 insomnia-disordered participants. dCBT was delivered using the Sleepio program (well worth a look-see, BTW) and an associated iOS app. Follow-up assessments were conducted at 4, 8, and 24 weeks.

At weeks 4, 8, and 24, dCBT was solidly associated with significant improvement in global health, mental well-being, and a significant reduction in sleep-related impairment to quality of life. And I’m thinking that means nighttime insomnia symptoms were reduced, as well.

Straight from the study…

The results of this definitive trial suggest that dCBT not only is effective in improving insomnia symptoms but also demonstrates positive effects around the clock by improving the functional health, psychological well-being, and sleep-related quality of life of people with positive screening results for insomnia disorder.
In addition, improved insomnia is a mediator of these benefits. These findings indicate that dCBT improves both daytime and nighttime aspects of insomnia, lending further weight to the clinical guideline recommendation of CBT as the treatment of choice for insomnia.

Let’s Put It to Bed

So, yes, insomnia relief goes well beyond pills, and it’s about way more than sleep. Given what you’ve read, does that make sense?

Sleep is so essential to our bodies – how we live our lives. And I gotta’ tell ya’ it really bugs me that I don’t do it well. But does it bug me enough to try some dCBT? We’ll see, won’t we?

You?

Be sure to check-out the full study piece in JAMA Psychiatry.

And while you’re at it, peruse hundreds of Chipur mood and anxiety disorder-related titles.