Cognitive-behavioral therapy for sleep

  Cognitive-behavioral treatments for sleep include stimulus control therapy, sleep restriction and relaxation therapy in addition to various behavioral education strategies. Recent clinical studies have shown that the rational application of these non-pharmacological treatments can significantly improve insomnia symptoms and the dosage of insomnia medications and reduce their adverse effects.  I. Stimulus control training includes: 1. Go to bed only when there is sleepiness; 2. If you cannot fall asleep when you go to bed for 10-20min, you should get up and go to bed only when by sleepiness; 3. No matter how long you sleep at night, you should get up on time early in the morning to maintain good sleep habits, sleep for a moderate amount of time and keep a rhythm; 4. Reduce the time in bed when you are not sleeping (such as watching TV or reading in bed), and make the bed and bedroom as a place that is only needed when sleeping; 5. Reduce the time of daytime naps.  It has been found that this method is effective for both types of insomnia: prolonged sleep latency and persistent sleep disorder in the elderly.  Second, sleeprestriction (sleeprestriction): The main method is to improve the efficiency of sleep by limiting sleep. Insomniacs are asked to reduce the amount of non-sleep time spent in bed. Glovinsky and Spielman believe that the standard should be reduced by 5% in the treatment of elderly patients. Adjustments are generally made on a weekly basis, but not less than 5 hours per night to avoid inducing adverse events and daytime sleepiness. A small number of naps may be allowed during sleep restraint therapy to ease the initial adjustment discomfort.  Chronotherapy: It is also a method of adjusting sleep time to re-establish normal sleep treatment and is mainly used in the treatment of Delayed Sleep-Phasesyndrome (DSPS). The bedtime and wake-up time of DSPS patients are delayed by 3 hours or advanced by 0.5~1.0 hours each day until the regular time.  Relaxation therapy: Relaxation therapy is suitable for patients who suffer from insomnia due to hypervigilance. Usually relaxation therapy alone is not effective for patients with chronic insomnia. Commonly used relaxation methods include muscle relaxation training, biofeedback, meditation, yoga, qigong and taijiquan, etc.  Cognitive therapy (connitivetherapy): It is believed that some insomnia patients have incorrect perceptions of sleep, including high expectations of sleep, lack of awareness of the occurrence of dreams during sleep, and lack of confidence in the treatment methods used. The physician should explain the misconceptions of the patient in a targeted way so that he or she can dispel the doubts and cooperate with the treatment. This method should belong to the category of psychotherapy.