36 - Non-pharmacological treatment of insomnia in the elderly: cognitive behavioral therapies

Summary

Insomnia is the most prevalent sleep disorder in older adults. Non-pharmacological treatment has been increasingly recognized as the preferred approach and data continue to support its efficacy. The dominant non-pharmacological treatment is cognitive behavioral therapy for insomnia (CBT-I). Cognitive behavioral therapy (CBT) represents a merger of these approaches, utilizing a combination of behavioral and cognitive strategies to effect change across domains of functioning. For all CBT-I approaches, an important component of treatment is maintaining a patient-completed sleep diary or sleep log. CBT-I is generally considered to be a safe therapeutic option with few known side effects. One important side-effect consideration is that of increased daytime sleepiness during the initial treatment period with CBT. The meta-analyses have found that CBT-I is associated with moderate to large effect sizes with larger improvements found in sleep latency (43% reduction) and nocturnal wakefulness (56% reduction) than in total time spent asleep.