Clinical insomnia affects roughly 10 percent of the population within their lifetime. As well as being generally unpleasant, it can trigger a whole range of physical health issues and mental illnesses, including cardiovascular disease, Alzheimer’s, and depression, not to mention the fact that it can cause your immune system to go AWOL and heighten your susceptibility to the common cold. But two simple behaviors – mindfulness-based therapy (MBT) and cognitive therapy (CT) – may be effective ways to tackle the disorder. That's according to a study recently published in the journal Behavior Change, which examined the processes behind changes observed in a 2016 study published in the journal Clinical Psychology & Psychotherapy.
Many people with insomnia try to relieve symptoms with sleeping pills, but that is not an effective long-term solution. In fact, (some) sleeping pills have been linked to declines in memory and psychomotor skills and rebound insomnia is a well-known phenomenon. That is when users become dependent on the pills to get a good night's rest. On top of that, according to Matthew Walker, a neuroscience professor at the University of California Berkeley, medically-induced sleep is probably not even real sleep. It's better to describe it as sedation.
Cognitive-behavioral therapy (CBT) has for a while now been the recommended first treatment, Ree added. It is a long-term solution compared to medication and three-quarters of people respond well to the therapy. So, for the study, Ree and a team of Australian researchers tested the effectiveness of four sessions of CBT combined with either four sessions of MBT or four sessions of CT on a group of people who had had six or more months of difficulty in initiating or maintaining sleep. The former involves meditation, acceptance, and training yourself not to become overwhelmed by anxious thoughts. The latter puts more emphasis on changing negative patterns of thinking around sleep to something helpful and productive. The researchers measured the success of these treatments using various questionnaires.
Both therapies improved cognitive process measures, and while MBT was less direct and did not actively focus on negative thoughts like CT, it did also change thought patterns. In terms of actual treatment and improved sleep, success was more accurately predicted by post-treatment scores on cognitive process measures rather than the type of treatment.
As the researchers noted in 2016, post-treatment scores on the Insomnia Severity Index (ISI) used to measure sleep quality dropped to 5.7 from 8.9 among those who completed CT treatment and to 6.7 from 9.9 among those who completed MBT treatment. These pre-treatment scores were already much lower than pre-CBT scores that averaged at around 17.8. Practically, this means that after completing CBT and CT or MBT, volunteers had moved from having sleeping difficulties to being in the "good-sleeper range".
“Interestingly, for the treatments to be effective, the content of peoples thoughts and beliefs needed to change – the more change in how people thought about their sleep, the better they responded to treatment,” explained Ree, reports Psypost. This essentially means that if you worry about sleep and go to bed thinking you won't get enough shuteye, you probably won't. Then there is your response to your lack of sleep, which could trigger another bad night's rest and then another. Think: drinking caffeine to keep alert during the day and canceling social occasions and gym sessions because you are feeling too drowsy.
It is worth mentioning that with just 57 volunteers, this was a relatively small-scale study and it would be interesting to see how the results fared when followed up with a larger group of participants.
As for the next steps, Ree told IFLScience: "There is accumulating evidence that points to change in cognitive processes being important for effectively treating insomnia, and that this change can possibly be achieved via mindfulness, cognitive therapy, or behavior therapy – being able to determine which therapy is likely to be best for a particular patient would be a real move forward."