Therapy better than pills if you have insomnia
INSOMNIACS should be prescribed therapy instead of sleeping pills, a study suggests.
It found cognitive behavioural therapy (CBT) tailored to tackle insomnia was better than medication, leading to ‘effective and enduring improvements in sleep’.
The analysis of 13 studies involving several hundred patients found CBT helps them fall asleep up to 30 minutes quicker on average and reduces waking up during the night.
The researchers from Queen’s University in Canada said that compared with sleeping pills, the therapy ‘has been shown to be superior in reducing symptoms of insomnia and in maintaining sleep improvements for years’.
Patients slept better after only four to six sessions of therapy.
Most courses of CBT for insomnia begin with a rigid sleep-restriction regimen to stop patients lying in bed awake at night for prolonged periods.
They are told to leave the bedroom after 20 minutes of struggling to get to sleep and limit the hours they spend in bed. Eventually sleep deprivation overrides any anxiety they feel at bedtime and slumber follows. The technique also involves sessions with a therapist and steps such as reducing caffeine, cutting back on napping and keeping a sleep diary to identify what might be causing the problem.
GPs can refer people for CBT on the NHS but patients often face lengthy waiting times to get it. Doctors can also prescribe sleeping pills but these can be addictive and lose effectiveness over time.
Professor Juliet Davidson, author of the study published today in the British Journal of General Practice, said: ‘There is now a way for GPs to help insomnia sufferers without prescribing drugs. Widespread studies have established that cognitive behavioural therapy for insomnia (CBT-I) is effective and lasting. It works well to get patients sleeping well again.
‘Current medical guidelines recommend CBT-I rather than sleeping pills.’
Up to a third of British adults suffer some form of insomnia. The sleep disorder is often triggered by stress and can lead to irritability, feeling low and daytime tiredness.
Professor Helen StokesLampard, chairman of the Royal College of GPs, said: ‘Sleeping tablets can seem like an obvious treatment option but they are not usually effective for more than a few days and GPs will use them only as a last resort.
‘CBT tailored to insomnia has been a first-line treatment option for some time and many patients have found it beneficial, so it is really positive that its effectiveness has been shown by this research today.
‘Unfortunately, access to treatments such as CBT in the NHS can be extremely difficult to come by and is very variable across the country.’
She added that GPs should be given access to more psychologists trained in CBT.