Philadelphia, 3 May 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 by the American College of Physicians (ACP), published in the latest issue of Annals of internal medicine.
THE’insomnia It is one of the major health care problems in the United States. About 6-10% of adults have this disorder, which is more present in women and the elderly and which are under diagnosed 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 they experience tiredness, cognitive function disorder, mood disorders and interference with normal daily operation. To be diagnosed like chronic insomnia The reduction of night sleep must be present for at least three nights per week for three months and not be a consequence of other medical or psychiatric pathologies.
For the drafting of the recommendations, the 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 they should receive the Cognitive behavioral therapy As an initial treatment for this disorder, since this has been an effective treatment and therefore to be started already in the field of basic medicine.
In support of this consideration, even if there have not emerged sufficiently reliable evidence to directly compare the superiority of this therapy compared to pharmacological treatment, there is the fact that TCC is a non-invasive therapy and with a potential better risk/benefit relationship with respect to the intake of hypno-inductive drugs.
In any case, it is desirable that the doctor evaluates the possibility of using one or the other therapeutic procedure together with the patient, considering the advantages, inconveniences and costs for each individual case.
However, it should be noted that the use of the drugs should be limited to a period no longer than four or five weeks, while the skills learned with the Cognitive behavioral therapy allow you to manage insomnia in the long run.
There TCC for insomnia It consists of a combination of treatments that include cognitive therapy concerning sleep, behavioral interventions (such as sleep restriction and stimulus control) and educational, relating to sleep hygiene information.
This method has the intention of pushing patients into an active participation towards the resolution of their disorder and in this way they were able to detect positive results from 70% to 80% of the patients treated.
Despite these evidence, in daily practice some factors hinder the use of this type of interventions. Firstly because, as already reported above, doctors do not consider insomnia as a disorder worthy of specific treatment; secondly since there are prejudices about the possibility of operating on these disorders with a psychological/behavioral measures; Thirdly for the insufficiency of expert staff in exercising this type of care, especially in the medical field.
