By Michael L. Perlis, Carla Jungquist, Michael T. Smith, Donn Posner
• CBT is a brand new, more and more well known approach to remedy that offers measurable effects and is hence reimbursed via insurance firms • name is sooner than the curve, there isn't any pageant • Concise, functional handbook • includes reader-friendly, role-playing routines to use to day-by-day perform
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Extra info for Cognitive Behavioral Treatment of Insomnia: A Session-by-Session Guide
The methodology uses motion detection and activity counts to assess whether the patient is awake or asleep. The actigraphic device itself resembles a wristwatch and the output data can be summarized graphically as activity counts over time or quantitatively. 2. ” The device produces minute-by-minute data that ultimately allows for the calculation of the usual compliment of sleep continuity variables. The primary strengths of this prospective measurement strategy are that it (1) allows for an assessment of sleep continuity that is free from either self report or observer bias, (2) requires minimal subject compliance, (3) has excellent temporal resolution (allows for the detection of periods of wakefulness as brief as 30 seconds in duration), (4) allows for the continuous assessment for periods of up to 60 days, (5) when combined with sleep diary data may allow for the detection of “sleep state misperception” (a condition where subjects appear by objective measures to be asleep but do not perceive themselves to be asleep), (6) may cause the patient to more veridically report their sleep continuity in the sleep diaries, and (7) may provide a measure of compliance with the prescribed aspects of treatment (prohibition against napping, and schedule bedtime and awake time).
5. Decide with the patient if “this is a good time” to invest the time and effort needed for Tx. 6. For patients using OTC or prescription sleep medications, determine whether they are willing to discontinue the use of these agents and explain the possible strategies. 7. Orient the patient to the process of keeping a sleep diary. If actigraphs are being used, orient the patient to the use of the actigraph. Explain why both measures are used. 34 Session One: Intake Evaluation (60 to 120 Minutes) 35 8.
SRT is thought to be effective for two reasons. First, it prevents patients from coping with their insomnia by extending sleep opportunity. This compensatory strategy, while increasing the opportunity to get more sleep, produces a form of sleep that is shallow and fragmented. Second, the initial sleep loss that occurs with SRT is also thought to increase the homeostatic pressure for sleep, which in turn produces shorter sleep latencies, less wake after sleep onset, and higher sleep efﬁciency. Finally, it should be noted that sleep restriction may also be contraindicated in patients with histories of mania, obstructive sleep aprea, seizure disorder, parasomnias or for those at risk for falls.