Sleep is an essential pillar of health.  As we sleep, a symphony of synchronized brain activity cleans, organizes and restores the nervous system, allowing all bodily systems to function in the way they were designed.  Without adequate sleep, the nervous system struggles to regulate itself, resulting in a multitude of symptoms, including pain, impaired tissue recovery, increased risk for injury, and overall fatigue, irritability, depression, etc. 

 

It is often difficult to determine what came first: insomnia or pain?  Sleep disruption or depression?  Insomnia often has a bi-directional relationship with other health concerns, which can be frustrating when you are on the losing end of this double whammy.  But this relationship also creates an opportunity.  If someone struggles with persistent pain AND insomnia, and all efforts to change the pain have fallen short, targeting sleep can actually break the pain cycle.  Studies show that when people struggle with comorbid (co-occurring) fibromyalgia and insomnia, comorbid chronic low back pain and insomnia, and comorbid depression and insomnia, effectively restoring sleep leads to significant improvement in fibromyalgia, back pain and depression symptoms. 

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Contrary to popular belief, the gold standard in treating insomnia is not sleep medication.  While medicine can be useful in the short term, it is only intended for up to four weeks of use. Long-term use of many popular sleep medications can undermine the natural ability to sleep and create other downstream health risks. 

 

The current best evidence demonstrates that Cognitive Behavioral Therapy for Insomnia, CBT-I, is 75-80% effective in improving sleep for people diagnosed with insomnia.  While it does take a commitment on the part of the person experiencing insomnia, the results can be life-changing.  Research has shown several encouraging outcomes with the use of CBT-I, including:

    - CBT-I reduces or eliminates the need for sleep medications in 90% of patients

    - 85% of long-term benzodiazepine users were able to eliminate their use for sleep

    - Six co-morbidities have been shown to improve due to sleeping better with CBT-I, including pain, fibromyalgia,                PTSD, menopausal hot flashes, depression and substance abuse

    - Improved sleep doubles the rates of symptom improvement in people with depression and insomnia compared to                antidepressant medications alone

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CBT-I combines education, sleep tracking, sleep schedule modification, movement, mindfulness techniques, and sleep hygiene principles to restore appropriate circadian rhythms and improve both the quantity and quality of sleep.  Sessions last 45-60 minutes, and on average, people require 5-6 sessions over 6-8 weeks for the full course of treatment.  

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Jessie Podolak, PT, DPT, is certified in CBT-I and provides these services here at Phileo Health Network.  To schedule, please email Jessie at jessiephileohealthpt@gmail.com.  There is special intake paperwork to complete, and Jess will talk with you about the details of the program while getting you scheduled.