Board of directors, American Academy of Sleep Medicine; and professor of medicine, UCLA David Geffen School of Medicine

Jennifer Martin, PhD

“Cognitive behavioral therapy (CBT) for insomnia doesn't work overnight, but it's pretty quick. Most patients experience some improvement in their symptoms within the first couple of weeks. Within a couple of months, a lot of patients experience complete remission of their symptoms.”

The most recent guidelines for the treatment of chronic insomnia disorder (CID) in adults published by the American Academy of Sleep Medicine (AASM) included a 

 for insomnia (CBT-I). Literature review demonstrated clinically meaningful improvements in critical outcomes and favorable information on cost-effectiveness of CBT-I.

 A number of studies published in the past year have suggested it is both 

woman both during pregnancy and post-childbirth

In 2017, the AASM updated clinical guidelines for the use of pharmacologic treated of CID that emphasized that medications should mainly only be used if CBT-I fails. Only weak positive recommendations were given to agents such as suvorexant, eszopiclone, zaleplon, zolpidem, triazolam, temazepam, ramelteon, and doxepin, while weak negative recommendations were made for the use of trazodone, tiagabine, diphenhydramine, melatonin, tryptophan, and valerian.

 reached out to Jennifer Martin, PhD, AASM board of directors, and professor of medicine, UCLA David Geffen School of Medicine, authors of the guideline, to learn more about CBT. Martin also discussed interactions between CBT and pharmacological treatments for CID.

1. Edinger JD, Arnedt JT, Bertisch SM, et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. 

. Published online November 9, 2020. doi: 10.5664/jcsm.8986
2. Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American Academy of Sleep Medicine clinical practice guideline. 

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The AASM board of directors' member and professor of medicine at UCLA discussed the benefits of CBT-I and its efficacy compared to pharmacological treatments. 

Cognitive Behavioral Therapy vs. Pharmacological Treatments for Insomnia: Jennifer Martin, PhD

"The main strength of cognitive behavioral therapy for insomnia is that it works for so many different kinds of patients... even in patients who had chronic medical issues, depression, or anxiety issues, along with their insomnia, the treatment is still very effective.”

 for the treatment of chronic insomnia disorder in adults by the American Academy of Sleep Medicine (AASM) included a strong recommendation for the use of cognitive behavioral therapy for insomnia (CBT-I). Conditional recommendations were made for multi-component brief therapies, stimulus control, sleep restriction therapy, and relaxation therapy. The AASM recommended against the use of sleep hygiene therapy as a single-component therapy.

The guidelines recommend that physicians should prescribe the use of CBT-I for almost all patients, based on a large body of moderate quality evidence from 49 studies, including multiple, recent, large randomized clinical trials. The AASM found clinically meaningful improvements in critical outcomes and favorable information on cost-effectiveness of CBT-I. A number of studies published in the past year have suggested it is both 

 reached out to one of the authors of the guideline, Jennifer Martin, PhD, AASM board of directors, and professor of medicine, UCLA David Geffen School of Medicine, to learn more about CBT and its strengths. Martin also discussed the strengths of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system in evaluating the efficacy of insomnia treatments.

Edinger JD, Arnedt JT, Bertisch SM, et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. 

Published online November 9, 2020. doi: 10.5664/jcsm.8986

The AASM board of directors member and professor of medicine at UCLA discussed some strengths of CBT. 

AASM’s Strong Recommendation for Cognitive Behavioral Therapy: Jennifer Martin, PhD

“The biggest challenge that we face in terms of treating insomnia is getting patients to talk to their healthcare providers about their sleep... A number of people are suffering from chronic insomnia problems, but they're reluctant to bring it up with their doctor or reach out for help. “

The American Academy of Sleep Medicine (AASM) has published new clinical guidelines for the treatment of chronic insomnia disorder in adults. The guidelines made a strong recommendation for the use of cognitive behavioral therapy, conditional recommendations for multi-component brief therapies, stimulus control, sleep restriction therapy and relaxation therapy. It recommended against the use of sleep hygiene therapy as a single-component therapy.

Among the authors of the guideline was Jennifer Martin, PhD, AASM board of directors, and professor of medicine, UCLA David Geffen School of Medicine. Martin and other members of the AASM conducted a comprehensive review of literature on insomnia and evaluated the efficacy of common treatments used.

 reached out to Martin to learn more about the challenges of treating chronic insomnia and the recommendations that were made. Martin urged physicians to ask their patients about their sleep and be proactive about catching chronic insomnia.

The AASM board of directors member and professor of medicine at UCLA also discussed the relative inefficacy of sleep hygiene therapy for insomnia. 

Jennifer Martin, PhD

Articles

Cognitive Behavioral Therapy vs. Pharmacological Treatments for Insomnia: Jennifer Martin, PhD

AASM’s Strong Recommendation for Cognitive Behavioral Therapy: Jennifer Martin, PhD

Challenges of Treating Chronic Insomnia: Jennifer Martin, PhD

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