Insomnia Research
Please remember that each and every patient responds differently to a medical intervention, and especially so to a psychological one. Therefore some of our patients might expect a greater improvement, whilst some will improve less than suggested below.
The studies summarized below show some of the improvements that are possible, results published in clinical trials are often slightly better than those obtained in real life clinical practice. Please bear in mind that studies suggesting adverse consequences of insomnia are for the most part so called population studies which have their limitations, further work is being done to confirm or refute their results.
Meta-analysis of CBT in Depression - Morin et al, 1994
A review of a number of studies involving over 2000 people with insomnia. Patients treated with CBT had were better off compared to 81% of untreated 'control' patients for time taken to fall asleep and 74% of untreated patients in terms of actually staying asleep. On average the time taken to fall asleep reduced from 64 minutes to 37 minutes, and the time spent awake after falling asleep fell from an average of 70 to 38 minutes.
Another meta-analysis of CBT in Insomnia - Murtagh and Greenwood, 1995
Total of 1538 patients studied. Time taken to fall asleep dropped on average from 61 to 37 minutes, total sleep time increased from 5.65 to 6.18 hours after treatment. From this review it was apparent that 70 - 80% patient's insomnia respond to CBT and that the overall average improvement is 50-60%.
CBTI vs relaxation therapy for Insomnia - Erdinger 2001.
Average total sleep time increased from 5.6 hours in the group receiving relaxation therapy only to 6.2 hours in the group who had CBTI. Sleep efficiency (% of time spent in bed actually asleep) increased from 76% to 84% with CBTI.
Non-depressed individuals with insomnia have double the risk of developing future depression
It is well known that depression and poor sleep are associated. Insomnia has usually been viewed as secondary to depressed mood. This study however shows that insomnia can come first, reduce the response to depression treatment, and indeed remain after depression has been treated. The study authors suggest that by treating insomnia as soon as possible may reduce the chances of later development of mood disorders.
Risk of an early death in men with Insomnia
In a recently US study 741 men with an average age of 50 were monitored over 14 yeas. Some frightening news for male insomnia sufferers - you are 4 times more likely to die young than men that sleep well. After 14 years 9% of those without sleeping problems had passed away, but an almost unbelievable 51% of those who had Insomnia (less than 6 hours sleep per night) had died. To put this into context, this suggests four times the risk of death before 70 years of age.
Exercise helps with sleep
A study performed by a well respected sleep researcher has shown that, in a group of middle aged women, regular aerobic exercise improves sleep and mood. Even relaxing forms of exercise, such as Tai'chi, wee not as effective.
Too much or too little sleep increase the risk of heart disease, high blood pressure, type 2 diabetes and obesity.
A link between short or long sleep duration and some of the world's biggest killer diseases - obesity, diabetes, hypertension and cardiovascular disease has been described. The study found that 7-8 hours of sleep per night is ideal and anything less or more confers an increased risk of these disorders.
A connection between short sleep and Alzheimer's
A study performed in mice suggested an increase in the build up of a protein, in mouse brains, that is known to be associated with Alzheimer's disease.
Short sleep linked with early death
Getting less than six hours sleep a night can lead to an early grave, UK and Italian researchers have warned.
They found that people regularly having less than 6 hours sleep per night were 12% more likely to die over a 25-year period than those who got an "ideal" six to eight hours. They also found an association between sleeping for more than nine hours and early death, although that much sleep may merely be a marker of ill health.
CBT I is useful in persistent Insomnia associated with cancer
Patients with cancer and persistent insomnia underwent CBT I, and on average experienced 55 minutes extra sleep after treatment concluded. This effect was still apparent 6 months after treatment.
The natural history of insomnia; a 3 year follow up study of 388 patients
74% reported insomnia for at least 1 year and 46% reported insomnia persisting over the entire 3-year study. The course of insomnia was more likely to be persistent in those with more severe insomnia at baseline and in women and older adults. Remission rate was 54%; however, 27% of those with remission of insomnia eventually experienced relapse. The study concluded that Insomnia is often a persistent condition.
Symptoms of Insomnia
Stare at the ceiling. Toss and turn. Glare at the clock. Toss and turn. It’s the typical pattern of insomnia.
But did you know that there is more than one symptom of insomnia? A new study of insomnia symptoms emphasizes that having trouble falling asleep is only part of the problem. And it’s not even the most common insomnia symptom. The results are published in the Aug. 1 issue of SLEEP.
The study involved 6,791 adults. They completed telephone surveys as part of the America Insomnia Survey (AIS). Insomnia was measured using the Brief Insomnia Questionnaire (BIQ). An estimated 24 percent of AIS participants had insomnia.
Results show that staying asleep was a bigger problem than falling asleep. Among people with insomnia, 61 percent had trouble “maintaining†sleep. They often woke up during the night. Also, 52 percent of people with insomnia woke up too early in the morning.
Only 38 percent of insomniacs had trouble “initiating†sleep. It took them at least 30 minutes to fall asleep at night.
In fourth place was “nonrestorative†sleep. Twenty-five percent of people with insomnia reported waking up still feeling tired or unrested.
Symptom combos also were common. More than half of people with insomnia had two or more of the four symptoms.
The study also measured the rates of 21 medical conditions. What were the most common problems? About 50 to 60 percent of people with insomnia had chronic back or neck pain, or other chronic pain. Seasonal allergies also were common. People with insomnia also rated their health lower than people without insomnia.
Many proven treatments for insomnia are available. Both cognitive behavioral therapy and medications are effective. A board-certified sleep specialist can determine which treatment is best for you.