Therapy Flashcards
CBT
Sleep onset insomnia treatment involves cognitive behaviour therapy. Usually involves 8-10 sessions with a psychologist which aims to correct dysfunctional thoughts and/or behaviours that hinder falling asleep. It involves two components, a cognitive component and a behavioural component.
Cognitive component
Correcting dysfunctional thoughts such as “I’ll never fall asleep” or “how am I going to cope tomorrow”. It involves becoming aware of these thoughts as they can be occurring automatically. These thoughts increases feelings of anxiety that themselves prevent sleep.
Behavioural component
Using discussions, questionnaires, etc to identify behaviours that contribute to difficulty falling asleep. These can include mental stimulation in the hour before sleep. Staying in bed if can’t sleep. Lights on or too much light in room.
Treatment for circadian phase disorders
Bright light therapy. Based on correcting the time of melatonin release so that it matches the time of the day (circadian rhythm) that people need to sleep given their lifestyle. It involves bright light shone briefly into eyes at regular intervals. Light in the morning if they travel east to west (multiple time zones.) Light in the night if sleep/wake cycle is earlier than should be.
Bright light therapy
Bright light therapy is used to treat people su ering from circadian phase disorders. In other words, it is used to advance or delay sleep depending on the type of circadian phase disorder.
When is the light received
Louis was diagnosed with delayed sleep-wake phase disorder. The light therapy was administered to him in the morning, at the time when his body really wanted him to sleep. People experiencing advanced sleep-wake phase disorder are likely to have bright light therapy in the evening, in an attempt to delay sleep.
How bright light therapy works
The bright light therapy signals to the brain’s suprachiasmatic nucleus that it is daylight, e ectively acting as a zeitgener. In turn, the suprachiasmatic nucleus can adjust the body clock, including ceasing the release of melatonin from the pineal gland.
Jet lag and bright light
People with jet lag may bene t from bright light therapy in the morning when they travel west to east, or in the evening when they travel from east to west.
Shift work and bright light
Shift workers often need to sleep during daylight hours. It can be very hard to correct the body’s response to a shift- work schedule, especially if it changes regularly or the worker wants to revert to standard daytime activities on their days o . However, bright light therapy may help to keep them awake during their night shift if they use it in the evenings as they go o to work.
Side effects of bright light
Although the side effects of bright light therapy are minimal, a specialist is required to ensure that the exposure is safe and consistent. It is not uncommon for the personto sustain eye irritations, dry skin, headaches and nausea, especially at the start of treatment.
