11/11/2023 0 Comments Cbt for sleep maintenance insomnia![]() ![]() Misattributions regarding the effects of sleeplessnessĬBTi is widely recognised in Australian and international sleep, medical, and primary care guidelines to be safer and more effective over time, when compared with pharmacological therapies.Inappropriate expectations about hours of sleep.Anxious and catastrophic thoughts that are associated with sleeplessness.Previously tried BBTi or online program which was not effectiveĬBTi addresses behaviours that maintain the insomnia and targets specific dysfunctional sleep-preventing attitudes and beliefsincluding:.Significant or very strongly held maladaptive or dysfunctional sleep-related cognitions (e.g., on the Dysfunctional Beliefs and Attitudes about Sleep Scale).Currently pregnant or caring for very young children.Severe or uncontrolled psychiatric condition (e.g., Bi-polar disorder, Schizophrenia disorder).People who drive or operate heavy machinery for work.Co-morbid sleep disorder (e.g., obstructive sleep apnoea, restless legs syndrome, circadian rhythm disorder).Identify patients suitable for CBTi from a ‘sleep’ psychologist, instead of an online program or BBTi: The main therapeutic components of Cognitive behavioural therapy for insomnia (CBTi) are: 1, 2ĬBTi, when compared to BBTi, is generally delivered over a 6-10 weekly/fortnightly sessions, includes longer appointments (approximately 30-45 minutes), a greater focus on cognitive therapy/restructuring, and is mainly administered by psychologists with specialist training/experience in the management of insomnia ( See Referral to a Psychologist). Cognitive Behavioural Therapy for Insomnia (CBTi).Brief Behavioural Therapy for Insomnia (BBTi).Basic Sleep and Sleep Hygiene Education.Pathogenesis, Risk Factors & Development.Insomnia - Steps in Assessment & Management.Treatment Options - Positional Therapy (PT).Treatment Options - Mandibular Advancement Splint (MAS).Treatment Options - Continuous Positive Airway Pressure (CPAP).(Suvorexant, zaleplon and ramelteon are not currently available in Canada, but zaleplon is available through compounding pharmacies.) Trazodone, melatonin, tryptophan, tiagabine and valerian are not recommended for treating insomnia ( Sateia et al., 2017).Īll of the newest hypnotics (eszopiclone, ramelteon, zaleplon, zolpidem) have been shown to be safe and effective in older adults. Some sedating agents have the potential for physical or psychological dependence and there are limited studies on the effects of long-term hypnotic use.Īccording to the most recent American Academy of Sleep Medicine clinical practice guidelines, the following medications can be used to treat insomnia: suvorexant, eszopiclone, zaleplon, zolpidem, temazepam, ramelteon and doxepin. Sleep-promoting agents (hypnotics or sedatives) are generally recommended for short-term treatment of insomnia if CBT is not available or accepted by the patient. Use with caution in children and in patients with lung diseaseĬaution with renal impairment and alcohol use Temazepam (Restoril): Benzodiazepine (GABA agonist) Cognitive Behavioural Therapy: An information guide for families. ![]()
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