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How CBT can break the cycle for those who feel anxiety at bedtime

By Libby Galvin @mailonline 5th October 2015

Apparently, we spend one third of our lives asleep. Not me. Ever since I was a child, most of the time everyone else has spent getting their beauty sleep, I’ve spent tossing and turning, exasperated at my inability to do what should be so natural.

Once I do finally drift off, within what seems like minutes my alarm clock is ringing and it’s time to start another day, exhausted and irritable. That is until I get home to bed, when suddenly my brain comes to life and the cycle starts again.

I’ve tried everything: avoiding caffeine, practising good ‘sleep hygiene’ such as avoiding using my mobile phone before bed, and blocking out light and sound with sleep masks and earplugs.

A couple of years ago I was prescribed the sleeping pill zopiclone, but there is a risk of addiction, and side-effects such as dizziness and headaches, and possibly confusion and anxiety, so my doctor recommended I use them only in emergencies and I’ve taken them only on the truly intolerable nights.

Up to 15 per cent of the population is afflicted by chronic insomnia (defined as a difficulty getting to or staying asleep most nights for a period longer than four weeks) and a third of us frequently suffer from poor sleep.

This has severe long-term implications for health, including lowered immunity, depression, type 2 diabetes, weight gain and high blood pressure – for me, at the age of 26, this is a pretty dismal prospect.

But what if curing insomnia was as simple as talking to someone about it?

Recent research suggests that cognitive behavioural therapy (CBT), a psychological therapy more commonly used to treat depression and anxiety, could successfully treat sleep problems.

CBT looks at how we think about situations, and how these thoughts affect the way we act and feel.

The idea is to change thinking patterns and behaviour to achieve a more positive outcome – in my case, getting to sleep.

In a review published this year examining 20 studies into the use of drug-free methods to tackle sleeplessness, the Melbourne Sleep Disorders Centre in Australia found that CBT cut the time it took for patients to fall asleep by an average of 20 minutes.

In another study conducted by Professor Jason Ellis, director of the Northumbria Centre for Sleep Research, 73 per cent of patients who had received CBT reported improvements in their sleep quality after three months compared to 15 per cent of those who had received no treatment

Could it help me? To find out, I booked a course of CBT at Efficacy, a CBT clinic in London. Lee Grant, the clinical director and an accredited specialist in CBT, explains: ‘For a lot of insomniacs, the thought, ‘I won’t be able to sleep’ sets off feelings of anxiety – both mental and physical – and this itself results in inability to sleep. CBT aims to break the cycle of worry that is causing the sleeplessness.’

I’m not convinced that it’s a fear of being unable to sleep that’s keeping me up at night – but as I’ve tried everything else to no avail, I head to my first session.

After establishing from a questionnaire that I don’t have another underlying psychological problem which could be causing my insomnia (for instance, depression), Lee suggests a programme of six to eight one-hour sessions.

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