Insomnia Among Students

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The first step in treating insomnia with CBT-I is to identify the underlying causes of the insomnia. People with insomnia should evaluate or have their sleep patterns evaluated and take into account all possible factors that may be affecting the person's ability to sleep. This would involve keeping a sleep diary or journal for a couple weeks. The journal will help identify habits of thought or behavior, stress, etc. that could be contributing to the person's insomnia.

After identifying the possible underlying cause and the factors contributing to the insomnia, the person can begin taking steps towards getting better sleep. In CBT-I these steps include stimulus control, sleep hygiene, sleep restriction, relaxation training, and cognitive therapy. Some sleep specialists will recommend biofeedback as well.

CBT-I has been found to be an effective form of treatment of insomnia. It is also effective in treatment of insomnia related to or caused by mood disorders. Those with PTSD have also shown improvement.

Stimulus control

Stimulus control aims to associate the bed with sleeping and limit its association with stimulating behavior. People with insomnia are guided to do the following:

go to bed only when they are tired

limit activities in bed to sleep and sex

get out of bed at the same time every morning

get up and move to another room when sleep-onset does not occur within ten minutes.

Sleep hygiene

Sleep hygiene aims to control the environment and behaviors that precede sleep. This involves limiting substances that can interfere with proper sleep, particularly within 4–6 hours of going to bed. These substances include caffeine, nicotine and alcohol. Sometimes a light bedtime snack, such as milk or peanut butter, is recommended. The environment in which one sleeps, and the environment that directly precedes sleep, is also very important. Patients should engage in relaxing activities prior to going to bed, such as reading, writing, listening to calming music or taking a bath. Importantly, they should limit stimulating activity such as watching television, using a computer or being around bright lights.

Sleep restriction

Sleep restriction is probably the most controversial step of CBT-I, since it initially involves the restriction of sleep. Although it is counterintuitive, it is a significant and effective component of CBT-I. It involves controlling time in bed (TIB) based upon the person's sleep efficiency in order to restore the homeostatic drive to sleep. Sleep Efficiency (SE) is the measure of reported Total Sleep Time (TST), the actual amount of time the patient is usually able to sleep, compared with his or her TIB.

Sleep Efficiency = (Total Sleep Time / Time In Bed)

First, Time In Bed is restricted to the Total Sleep Time

Increase or decrease TIB weekly by only 20-30 min

Increase TIB if SE >90%

Decrease TIB if SE

This process may take several weeks or months to complete, depending on the person's initial Sleep Efficiency and how effective the treatment is for them individually. Daytime sleepiness is a side-effect during the first week or two of treatment, so those who operate heavy machinery or otherwise cannot safely be sleep deprived should not undergo this process.

Relaxation training

Relaxation training is a collection of practices that can help people to relax throughout the day and particularly close to bedtime. It is useful for insomnia patients with difficulty falling asleep. However it is unclear whether or not it is useful for those who tend to wake up in the middle of the night or very early in the morning. Techniques include hypnosis,guided imagery and meditation.

Cognitive therapy

Cognitive therapy within CBT-I is not synonymous with versions of Cognitive Behavioral Therapy that are not targeted at insomnia. When dealing with insomnia, cognitive therapy is mostly about offering education about sleep in order to target dysfunctional beliefs/attitudes about sleep.

Cognitive therapists will directly question the logical basis of these dysfunctional beliefs in order to point out their flaws. If applicable, the therapist will arrange a situation for the individual to test these flawed beliefs. For instance, many insomniacs believe that if they don't get enough sleep they will be tired the entire following day. They will then try to conserve energy by not moving around or by taking a nap. These responses are understandable but can exacerbate the problem, since they do not generate energy. If instead a person actively tries to generate energy by taking a walk, talking to a friend and getting plenty of sunlight, he or she may find that the original belief was self-fulfilling and not necessarily true.

Worry is a common factor of insomnia. Therapists will work to control worry and rumination with the use of a thought record, a log where a person writes down concerns. The therapist and the patient can then approach each of these concerns individually.

THIRD ARTICLE

Insomnia, also known as trouble sleeping, is a sleep disorder in which there is an inability to fall asleep or to stay asleep as long as desired. While the term is sometimes used to describe a disorder demonstrated by polysomnographic or actigraphic evidence of disturbed sleep, this sleep disorder is often practically defined as a positive response to either of two questions: "Do you experience difficulty sleeping?" or "Do you have difficulty falling or staying asleep?"

Insomnia is most often thought of as both a medical sign and a symptomthat can accompany several sleep, medical, and psychiatric disorders characterized by a persistent difficulty falling asleep and/or staying asleep or sleep of poor quality. Insomnia is typically followed by functional impairment while awake. Insomnia can occur at any age, but it is particularly common in the elderly. Insomnia can be short term (up to three weeks) or long term (above 3–4 weeks); it can lead to memory problems, depression, irritability and an increased risk of heart disease and automobile related accidents.\

Insomnia can be grouped