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Insomniacs could be helped by more trained therapists

Wider access to a talking therapy could increasingly be a successful alternative to sleeping pills for people with insomnia
WebMD UK Health News
Medically Reviewed by Dr Farah Ahmed

17th August 2012 - People with insomnia in England could increasingly access alternative treatment to sleeping pills because of the success of a new training programme for therapists in the NHS, say academics.

Trials led by Loughborough University found that CBT ( cognitive behaviour therapy) for insomnia can benefit people with the condition at any age.

Insomnia is difficulty getting to sleep or staying asleep for long enough to feel refreshed afterwards. People with insomnia are likely to feel irritable and tired and have trouble coping when they are awake.

A common problem

In Britain, people report having insomnia more often than any other psychological condition, including anxiety, depression and even pain, according to the Office of National Statistics. Patients with the condition may be prescribed sleeping pills or a course of CBT. Sometimes this is carried out by a trained GP or by referral to a clinical psychologist.

Professor Kevin Morgan of Loughborough University, who led the trials, explained to us the concept of Cognitive Behaviour Therapy for Insomnia (CBTi). "It is a question of encouraging insomnia sufferers to think about their sleep in a different way and to change the habits that bring about their sleep problems," he says.

Skills shortages

One barrier to CBTi has been the lack of trained counsellors in the health service. Professor Morgan says that what his team has done is develop a way of expanding those skills in the NHS. "What we've been doing is looking at ways of training staff who are already using CBT - albeit primarily for anxiety or depression - and adjusting their skills base so that they can now deliver Cognitive Behaviour Therapy for insomnia."

He adds: "England could be on one of the best places in Europe to have insomnia. It could be one of the few places where there is a uniformly trained, high quality standard, widely geographically distributed workforce, that can deliver CBT in preference to drug therapy for insomnia that affects around 10% of the population."

Professor Morgan's group has delivered training for therapists in health authorities in many parts of the country. "Every Parkinson’s disease nurse in Scotland has been trained in CBTi and new courses are planned for Oxford and South Yorkshire," he says.

Self help

The trials involved delivering the principles of cognitive behavioural management for insomnia in a structured programme of ‘self-help’. Patients were given six weekly booklets that explained how sleep works and how to gain control of it. They were also given access to a helpline, staffed by ‘expert patients’ who had experienced insomnia themselves.

Their success in coping with insomnia was compared with a control group in which people were handed a single sheet of advice detailing standard sleep hygiene measures.

The findings are based on a project about how to improve sleep among older people which is being carried out by the universities of Surrey, Bath and Loughborough. It is being funded by the Economic and Social Research Council.

Reviewed on August 17, 2012

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