Philadelphia, May 3, 2016 – Cognitive behavioral therapy (TCC) for insomnia should be the first choice treatment for adults with chronic insomnia, as recommended in a new clinical practice guide from the American College of Physicians (ACP), published in the latest issue of the Annals of Internal Medicine.
L ‘ insomnia is a major health care problem in the United States. About 6-10% of adults have this disorder, which is more present in women and the elderly and which is underdiagnosed because both doctors and patients sometimes do not recognize insomnia as a health problem, often considering it only as a symptom of little importance or in any case linked to contingent circumstances.
People with insomnia often experience fatigue, impaired cognitive function, mood disturbances , and interference with normal daily functioning. To be diagnosed as chronic insomnia, the reduction in nocturnal sleep must be present for at least three nights a week for three months and not be the result of other medical or psychiatric diseases.
To draft the recommendations, ACP researchers carried out a systematic review of studies published between 2004 and 2015.
The first suggestion arising from the analysis of these works is that all patients with chronic insomnia should receive cognitive behavioral therapy as an initial treatment for this disorder, as this has proved to be an effective treatment and therefore to be started already in the basic medicine.
In support of this consideration, even if no sufficiently reliable evidence has emerged to directly compare the superiority of this therapy with respect to pharmacological treatment, there is the fact that TCC is a non-invasive therapy and with a potential better risk / benefit ratio. compared to taking hypno-inducing drugs.
In any case, it is desirable for the doctor to evaluate together with the patient the possibility of using one or the other therapeutic procedure, considering the advantages, drawbacks and costs for each individual case.
However, it should be noted that the use of drugs should be limited to a period no longer than four or five weeks, while the skills learned with cognitive behavioral therapy allow to manage insomnia in the long term.
The TCC for insomnia consists of a combination of treatments that include cognitive therapy on sleep, behavioral interventions (such as sleep restriction and stimulus control) and educational, information related to sleep hygiene.
This method has the intent to push patients to an active participation towards the resolution of their disorder and in this way it was possible to detect positive results from 70% to 80% of treated patients.
Despite this evidence, in daily practice some factors hinder the use of this type of intervention. First of all because, as previously reported, doctors do not consider insomnia as a disorder worthy of specific treatment; secondly, because there are prejudices regarding the possibility of operating on these disorders with psychological / behavioral measures; thirdly, due to the lack of experienced personnel in exercising this type of care, especially in the medical field.
