Chronic Insomnia Treatments

chronic insomnia treatmentsA recent study confirms that cognitive behavioral therapy is effective for chronic insomnia and is often more effective than medications.

“What surprises us is that there isn’t more awareness of this treatment’s effectiveness and that there haven’t been more attempts to make the treatment more available to patients,” James M. Trauer of the Melbourne Sleep Disorders Centre in Australia told Reuters Health by email.

The researchers analyzed 20 randomized, controlled trials of cognitive behavioral therapy to determine what effects it had on the sleep of people with chronic insomnia not caused by an underlying medical condition.

The researchers note perhaps 15% of people have chronic insomnia. Chronic insomnia is associated with health, mental health and cognitive impairments.

The 20 studies included more than 1,000 patients.

On average, people in the therapy groups reduced the time it takes to fall asleep by 19 minutes after treatment and spent 26 fewer minutes waking up in the night according to an online report of the study posted June 8th in Annals of Internal Medicine.

You might be thinking that that’s not much of an effect.

However recent meta-analysis of 105 studies of medications for chronic insomnia (Buscemi – see reference below) found that on average medications commonly used for insomnia were associated with falling asleep about 11 minutes faster than before treatment, which is slightly more than half the improvement seen in the study of cognitive behavioral therapy.

The authors of the study of cognitive behavioral therapy suggests that cognitive behavioral therapy should be the first treatment option selected. Instead, in clinical practice it’s often not mentioned at all.

Part of the problem is that cognitive behavioral therapy for insomnia is surprisingly difficult to access in many parts of the country.

For more than a year we’ve been offering readers of this blog access to an excellent program of online cognitive behavioral therapy that many have found leads to significant long term improvement in their sleep.

Using this program requires work and a certain amount of commitment but the results are enduring.

This link takes you to information about that program (at the bottom of the page).


Trauer JM, Qian MY, Doyle JS, W. Rajaratnam SM, Cunnington D. Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis. Ann Intern Med. [Epub ahead of print 9 June 2015] doi:10.7326/M14-2841

The efficacy and safety of drug treatments for chronic insomnia in adults: a meta-analysis of RCTs. Buscemi N, Vandermeer B, Friesen C, Bialy L, Tubman M, Ospina M, Klassen TP, Witmans M. J Gen Intern Med. 2007 Sep;22(9):1335-50. Epub 2007 Jul 10. PMID: 17619935 itive behavioral therapy is relatively unfamiliar to and underused by medical practitioners.”