Sleepless No More: Techniques and Interventions for Sleep Disorders

Disturbed sleep has a significant impact on daytime functioning, mood and quality of life. Sleep disorders are among the most common conditions that affect the general population. Sleep initiation and maintenance difficulties have been associated with mood disturbance, fatigue, occupational impairment, higher morbidity and higher health care costs. Individuals with insomnia often do not seek treatment and when they do they typically initiate over-the-counter sleep medications or alcohol. Furthermore, when they reach out to the medical profession they are, most commonly, prescribed hypnotic medication. There has been increased recognition of the role of psychological and behavioral factors in etiology, assessment and treatment of certain sleep disorders. However, despite this, many mental health professionals are unaware of non-pharmacological treatments for sleep disorders and/or lack the knowledge to recognize and identify sleep problems and implement specific interventions. Sleep disturbance has seldom been the focus of general psychotherapy and empirically validated non pharmacological treatments are rarely used outside sleep disorder centers. The purpose of this paper is to provide mental health professionals with a practical framework for the assessment and management of common sleep disorders seen in clinical practice. Evidence based practice parameters and consensus-based recommendations will be reviewed. Non pharmacological therapies including stimulus control, progressive muscle relaxation, light therapy, sleep restriction, and cognitive-behavior therapy will be presented. Their efficacy when used in clinical practice by non-sleep specialists is well documented. Use of behavioral and psychological treatments for sleep disorders has been found to lead to improvements in sleep quality that are sustained long term and long after treatment completion. Reduction in sleep difficulties improve quality of life and lead to a reduction in hypnotic medication use and dependence.