Cognitive Therapy May Be Safe and Effective For Chronic Insomnia Interview with:
Dr David Cunnington
Sleep Physician & Director
Melbourne Sleep Disorders Centre
East Melbourne Australia

Medical Research: What is the background for this study? What are the main findings?

Response: Insomnia is a very common problem with 15-20% of adults having chronic insomnia, that is, trouble getting to sleep or staying asleep most days for  3 months or more. The most commonly used treatment is sleeping pills or hypnotics, however, they don’t address the underlying disorder, and come with potential side effects. Also, sleeping tablets just mask the symptoms, and as soon as tablets are stopped, symptoms recur. People with chronic insomnia think and behave differently around sleep, which perpetuates their symptoms. The key to improving symptoms in the long run is addressing thoughts and behaviours around sleep, which is what cognitive behaviour therapy does.

Our study showed that cognitive behaviour therapy reduced the time taken to get to sleep by 20 minutes and reduced the amount of time spent awake after falling asleep by nearly 30 minutes. These effects were maintained out to 12 months after treatment. These reductions in time taken to get to sleep and time spent awake are similar to those reported in clinical trials of hypnotics. 

Medical Research: What should clinicians and patients take away from your report?

Response: Cognitive behaviour therapy is an effective treatment for chronic insomnia, that is safe and produces long-term results. As such, it should be considered as a first line treatment for chronic insomnia, and is a valid alternative to using hypnotic medications.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: This systematic review and meta-analysis has shown that cognitive behaviour therapy is effective. However, barriers to this treatment being more widely available are lack of skilled practitioners, cost and access to healthcare. Future research should look at how cognitive behaviour therapy can be made more accessible using new technologies.


Drug-free sleep solution: Cognitive behavior therapy effective for chronic insomnia

James M. Trauer, MBBS; Mary Y. Qian, MBBS; Joseph S. Doyle, PhD; Shantha M. W. Rajaratnam, PhD; and David Cunnington, MBBS

Ann Intern Med. Published online 9 June 2015 doi:10.7326/M14-2841

Dr David Cunnington Sleep Physician & Director, Melbourne Sleep Disorders Centre, & East Melbourne Australia (2015). Cognitive Therapy May Be Safe and Effective For Chronic Insomnia

Last Updated on June 10, 2015 by Marie Benz MD FAAD