Knowledge Is Key to Curing Insomnia

April 10, 2001 -- A little bit of knowledge could help you sleep through the night.

A new study says that when people with sleep maintenance insomnia (or people who wake up during the night) are given more knowledge about effective sleep habits they are able to sleep more.

"Typically, if you have more than 30 minutes of awake time in the middle of the night then you are classified as having sleep maintenance insomnia," according to Dr. Jack Edinger, lead author of the study lead author of the study published in this week's Journal of the American Medical Association.

"By using typical cognitive behavioral therapy we were able to get most of the patients below the 30 minute time."

Cognitive behavioral therapy is a psychotherapeutic technique that combines changing an individual's beliefs and attitudes about sleep and then teaching that person how to use new habits to improve his sleep.

"We found that when people had faith in themselves, in their ability to sleep they actually slept more," Edinger said.

Mind Over Insomnia

In the study, researchers at Duke University Medical Center and the Veterans Affairs Medical Center, both in Durham, North Carolina, divided a group of 75 men and women with insomnia into three groups. Each group received either cognitive behavioral therapy, relaxation training or placebo therapy for six weeks.

Those receiving cognitive therapy saw significant reduction in their wake time after sleep onset. The sleep improvement for the cognitive therapy group lasted through six months of follow-up observations.

The study tried to correct misconceptions people have about their own sleep needs and habits. Patients were given information packets about sleeping techniques. Any unique problems a participant had with sleeping, such as failing to be able to relax or being distracted by television, were addressed individually.

Some of the common misconceptions about sleep that lead to insomnia is the myth that everyone needs eight hours of sleep a day to function, that once you get older you can sleep all you want and that sleeping late in the morning can help you catch up on what you lost at night.

"Those things are dysfunctional and can sustain sleep trauma," Edinger said. "For one thing you put stress on yourself by making these kinds of rules and stress keeps people up at night."

Elderly and Adults Had Positive Results

Edinger recommends that people avoid napping, schedule a standard wake-up time no matter what time you go to bed and to to go another room if you can't sleep at night. Restricting your actual time in bed helps. The strategies worked well for both the elderly and the younger patients, he said.

The most common way to treat insomnia, especially sleep maintenance insomnia is with drugs. The elderly are even more likely to be prescribed drugs and are usually the patients studied for insomnia treatment. But this study looked at men and women ranging in age from 40 to 80 years old.

"This study shows quite clearly that a cognitive behavioral insomnia therapy can be effective for people who have difficulty staying asleep at night," Edinger said. "Many patients were able to reach fairly normal levels of sleep with this treatment and without the use of sleeping pills."