Cognitive-behavioral therapy of insomnia
The advantage of this method is the absence of any negative side effects, non-specificity (possible use in any form of insomnia), and long duration of the positive effect after treatment compared to other treatments.
Cognitive techniques include explaining to the patient the basics of sleep physiology, sleep hygiene in order to correct distorted or inflated expectations about the duration or quality of their sleep.
The most well-known forms of behavioral therapy for insomnia are:
1. Relaxation training (self-training of abdominal breathing training), stimulation control therapy (go to bed only when you feel drowsy, if during 20 minutes in bed in the evening or at night the patient does not fall asleep – get up, do something neutral; when there is a feeling of drowsiness return in bed).
2. Sleep restriction therapy (to limit the time spent in bed during the time during which, according to the patient, he sleeps. Then, if subjectively he begins to feel that at least 85% of this time he really spends in his sleep, give him the opportunity to increase the time spent in bed for 10 minutes every 3 days).
3. Bright light therapy. Patients who sleep long enough, but at an inadequate time of day or night, adjust the rhythm of sleep and wakefulness under the influence of bright light.
4. Observance of sleep hygiene. The main recommendations for maintaining proper sleep hygiene are:
- ensuring comfortable sleep;
- reducing the level of physical and mental activity before bedtime;
- exclusion of stimulants and foods;
- establishing and following a regular routine of getting up and falling asleep (sleep mode);
- use the bed only for sleep.
If the use of non-medicine methods does not help (for several months), sedatives and hypnotics are added to the treatment of insomnia.
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