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One of the most common difficulties I run into with clients is undiagnosed sleep problems. Insomnia is a symptom of a wide range of psychological conditions including depression, anxiety disorders, substance use disorders, marital conflict and many others. It is also a condition by itself. Many people suffer from sleep problems for years, not realizing that treatments are available, or not knowing what treatment option to pursue.
A recent research article published in the Journal of the American Medical Association (JAMA)1 compared treatments for chronic insomnia. The study sought to determine the best combination of treatment for insomnia when medication and therapy were available. The authors compared Cognitive-Behavior Therapy and medication (Ambien, 10mg) in various combinations as a short-term and a long-term treatment for insomnia to determine the best long-term solutions for sleep difficulty.
They found that the most effective treatment combination out of all of these was a combination of therapy and medication initially, followed by therapy alone.
"Great, so what does this mean for me and my sleep problems?”
When I work with people who suffer from insomnia, I often recommend they go talk with their family doctor about a short-term prescription sleep aid to help re-establish a regular sleep pattern. That can often provide immediate relief while we work on long-term solutions in therapy. There are many, many things that can be done behaviorally to help sleep problems, but sadly people are unaware of how treatable insomnia is. Later in therapy when some of the initial fatigue and distress are relieved, the goal becomes to no longer need the medication and learn the tools needed to achieve normal sleep patterns again.
“So what should I do….the medications or therapy?”
It depends. Come see us for an evaluation so we can give a complete answer. That being said, research tells us that most people benefit from either, but get the most benefit from both (in the right context and with the right goals), and the most lasting results with therapy.
“What about over-the-counter (OTC) sleep aids”?
These are generally not a good option, especially long-term. Some sleep aids tend to interfere with the stages of sleep that you go through at night, and don’t allow you to get the full benefits of natural sleep. They can also have dangerous interactions with other medications, dietary supplements and alcohol. Your family physician can help select a medication that fits your specific problem, and that will not have the long-lasting side effects of many OTC sleep aids. We can help with long term behavioral solutions.
“Great, but what can I do about my sleep right now?”
· Well, let’s start with a few simple sleep hygiene tips that apply to all of us. You brain should associate bed with sleep (well, and intimacy…but that’s another article) Sometimes we associate it with other things as life gets busier (Facebook or work, anyone??)
· If you read or watch TV in bed, try doing that in a chair near you bed, or better yet, another room. It sounds simple, but it helps to re-train your brain to fall asleep when you climb into bed.
· Also, never spend more than 20 minutes in bed awake (tossing and turning). Get up and go do something mildly distracting for 15 minutes and try again. Repeat as many times as it takes.
· As far as eating and drinking go, try to limit your intake within a couple hours of bedtime. If you’re too hungry to sleep, try a light snack. People sometimes ask me “what do my dreams mean”. I usually joke “it depends on what you ate for dinner”.
· No caffeine after noon, until you get your sleep patterns back. Caffeine can stay in your system for over 6 hours.
· Finally, if you like things dark in the morning, try exposing your eyes to sunlight as soon as you can stand it in the morning. Your brain has a chemical “stopwatch” that starts each day when natural light hits your eyes, and triggers the release of hormones that help you fall asleep that night.
And schedule an appointment for a professional sleep evaluation with us. We can help get you moving towards peaceful sleep again!!
Jeremy Bidwell, Ph.D.
M.S. Clinical Psychopharmacology
Heartland Counseling
(630) 365-0899, ext. 106
Charles M. Morin; Annie Vallieres; Bernard Guay; Hans Ivers; Josee Savard; Chantal Merette; Celyne Bastien; Lucie Baillargeon.Cognitive Behavioral Therapy, Singly and Combined With Medication, for Persistent Insomnia: A Randomized Controlled Trial JAMA. 2009;301(19):2005-2015.
Girls and women have made dramatic strides toward gender equality in the United States. Role models and opportunities for girls in science, technology, and sports exist today that were not available 50 years ago. Despite these advances, results from a new study show that teenage girls from diverse ethnic and economic backgrounds continue to experience sexism. The findings are from a study of 600 girls between the ages of 12 and 18 from California and Georgia. The girls were Latina (49%), White (23%), African American (9 %), Asian American (7.5%), and multi-ethnic or other (7.5%), and came from a variety of socio-economic backgrounds. The study, the first to examine social and individual influences on girls’ personal experiences of sexism, was carried out by researchers at the University of California Santa Cruz and the University of Kentucky. It appears in the May/June 2008 issue of the journal Child Development.
Obesity is a well known risk factor for certain physical health problems, but a new study suggests that heavy adults also have higher rates of psychiatric disorders.
Using data from a national health survey of more than 40,000 Americans, researchers found that obese adults were up to twice as likely to suffer from depression, anxiety and other mental health conditions as normal-weight adults.
In addition, even moderately overweight people had elevated rates of anxiety disorders, the study found.
Although children as young as 5 can be diagnosed with obsessive-compulsive disorder (OCD), few research studies have looked at treatments specifically geared toward young children with this disorder. Now, a new study from the Bradley Hasbro Children’s Research Center provides some of the first evidence-based data on a successful intervention for early childhood OCD. According to the study’s findings, published in the May issue of the Journal of the American Academy of Child and Adolescent Psychiatry, children with OCD between the ages of 5 and 8 may benefit from a form of psychotherapy, known as family-based cognitive behavioral therapy (CBT), that is uniquely tailored to the child’s developmental needs and family context. The overall focus of family-based CBT is to provide both child and parents with a set of tools to help them understand, manage and reduce OCD symptoms. “If left untreated, early childhood OCD can severely disrupt and impair a child’s development and functioning and can extend into adulthood. Despite this risk, clinicians do not have a proven treatment model for these young children,” says lead author Jennifer B. Freeman, Ph.D., of the Bradley Hasbro Children’s Research Center and an assistant professor of psychiatry/human behavior (research) at The Warren Alpert Medical School of Brown University.
New research appearing in the May issue of Psychological Science, a journal of the Association for Psychological Science, suggests that being put in a low-power role may impair a person’s basic cognitive functioning and thus, their ability to get ahead.
Does playing violent video games make players aggressive? It is a question that has taxed researchers, sociologists, and regulators ever since the first console was plugged into a TV and the first shots fired in a shoot 'em up game.
Perhaps no period of life is more fraught with obsessive worries about popularity, social hierarchies and reputations than that treacherous, three-year period known as middle school. The social anxieties of adolescence have driven plotlines from "The Wonder Years" to "Hannah Montana" where teens and pre-teens spend entire hours and episodes agonizing over what their peers think. Figuring out whether you'll end up being a cool prom king or queen bee--or the kid who eats alone in the cafeteria--is an integral part of becoming a teenager. Turns out, it doesn't necessarily matter. Whether or not your high class voted you "most popular," teenagers who perceive themselves as well liked are just as socially successful over time as the kids who actually are part of the in-crowd, according to a new study in the May-June issue of Child Development. In fact, the overlap between the kids who believe they're popular and those who are deemed popular by their peers is pretty small. "Certainly there's a subset that feels good about themselves and is also popular, but that isn't the majority," says Kathleen Boykin McElhaney, a research associate in psychology at University of Virginia who conducted the study. Her findings add to a growing body of research suggesting that our perception of how we fit into the social world is just as important--if not more important--than our real-life position in the social world. The researchers asked 164 students at a public middle school to tackle a nerve-wracking question: how well liked were they among their class? McElhaney gauged the students' popularity within the class with assessments from the teenagers' peers, asking them who they would "most like to spend time with on a Saturday night." She also had close friends rate the subjects' aggression and hostility, saying whether statements like "is mean to others" applied to the teen in question. The study began with a group of 13-year-olds; McElhaney checked back in with them a year later to gauge whether each teen was doing better or worse socially. "We were measuring their aggression and hostility, along with a peer rating of whether people want to hang out with the teen," she explains. Half of her finding wasn't particularly surprising: the popular kids fare great socially, with their peers becoming more interested in hanging out with them over the year. But the teenagers who felt good about their place on the social ladder did just as well; they became less hostile and their peers became more interested in spending Saturday night with them even if they weren't ranked as particularly well liked. "If you're popular, sure, you do well, but the same is true if you felt that you were socially accepted," says McElhaney. "And if you look at both of those effects together--popularity and self-perceived social acceptance, we found that either one was OK." The one group of teenagers who did not fare well socially were those who did not perceive themselves as well liked and were not ranked as popular by their peers. These kids were viewed as more hostile toward their peers as the year went on and they were less sought out by their classmates over time. "They're not at all on the radar screen," says McElhaney. "They don't see themselves as accepted and that's where it's most problematic, when you don't have either that popularity or sense that you're well liked."
approximately 905,000 U.S. children were victims of maltreatment that was substantiated by state and local child protective services (CPS) agencies (1).* Approximately 19% of child maltreatment fatalities occurred among infants (i.e., persons aged <1 year) (1), and homicide statistics suggest that fatality risk might be greatest in the first week of life (2).
