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National Public Radio (NPR)
SHOW: Morning Edition 11:00 AM EST NPR
June 21, 2005 Tuesday
LENGTH: 795 words
HEADLINE: New treatment to help insomniacs does not involve medication
ANCHORS: STEVE INSKEEP
REPORTERS: ALLISON AUBREY
BODY:
STEVE INSKEEP, host:
If this is the kind of news that keeps you up at night, not to worry. We can help you with that.
Some insomnia researchers meeting at the National Institutes of Health have come to a new
consensus about what helps us to sleep. The treatment that they say works does not involve
taking a sleeping pill. NPR's Allison Aubrey reports on talk therapy.
ALLISON AUBREY reporting:
It's called Cognitive Behavior Therapy, and Harvard psychiatrist Gregg Jacobs practically
sounds like he's testifying in favor of it.
Dr. GREGG JACOBS (Psychiatrist): Cognitive Behavioral Therapy has been shown now in
federally funded research and med analyses to be as effective for insomnia as sleeping pills.
The problem with Cognitive Behavioral Therapy, it's not widely available.
AUBREY: There are fewer than a hundred certified therapists in the country. Researchers at
Duke University are trying to bring a condensed model to primary care doctors so more people
have access. Gregg Jacobs has spent the last 20 years fine-tuning and testing CBT. The first
thing he does with patients is to give them a quiz. The point is to clear up their misconceptions
about sleep. The first question he asks is `Do you think people need eight hours of sleep a
night to stay healthy?'
Dr. JACOBS: A lot of insomnia patients think that's the case. Actually, three major studies now
have shown that people who live the longest sleep seven hours a night, not eight.
AUBREY: Next question is `Do you think you're accurate in estimating how much sleep you
get each night?'
Dr. JACOBS: Insomnia patients are not. They're getting more sleep than they think.
AUBREY: The other main teaching tool is a 24-hour sleep diary. Jacobs has developed a
computer program to analyze patients' entries. It's something people might eventually use on
their own.
Dr. JACOBS: This'll show how many nights you're not awake for more than a half-hour during
the night, increases in your total sleep time, and if you're using sleeping pills, reduction in
your sleeping pill use.
AUBREY: The beauty of the sleep diary is self-awareness. Bill Moorcroft runs a sleep clinic in
Ft. Collins, Colorado, and has been using CBT for several years. He says with sleep diaries,
patients are their tracking results every day.
Dr. BILL MOORCROFT (Runs Sleep Clinic): It's been learned that when people pay attention to
their sleep and actually write down what's happening, sometimes they realize it's not as bad
as they thought.
AUBREY: He says the sleep diaries really give patients a true picture of sleep and help them
clear up misperceptions; that's the cognitive, or thinking, part of CBT. Next comes changing
behavior. Moorcroft says it's usually bad habits that keep us awake.
Dr. MOORCROFT: And so we turn those around, reduce the bad habits, increase the number of
good habits and teach them how to have some control over their mind and their thoughts and
their attitudes about sleep.
AUBREY: Patients are told to go to bed and wake up at the same time every day; no TV or
reading in bed, and when they do have those nights where they can't break free from a
restless mind, he tells them get out of bed.
Dr. MOORCROFT: When you're in bed, you're there to sleep, so that bed becomes firmly
associated with sleep and nothing else.
AUBREY: Moorcroft teaches patients who continue to struggle with a restless mind to sort of
schedule worry time during the day. They're told to keep journals and jot down concerns and
anxieties as they have time to think about them.
Dr. MOORCROFT: Spend a half-hour a day just writing these things down and processing
them. Then at night if these worries pop up, they can say, `I don't have to worry about you
now. Go away. I took care of you during my worry time.'
AUBREY: So say you're in bed, you've silenced your worries and it's time to relax. Learning
how to unwind is part of the behavior therapy. The technique Moorcroft teaches is a form of
visual imagery akin to counting sheep. He has his patients memorize and repeat a little
vignette in their minds. The story starts with them envisioning themselves at the beach.
Dr. MOORCROFT: `I feel the bright, warm sun on my face. Then I walk down a small
embankment to the sand. Eventually I close my eyes, I listen to the waves.' So that's the end
of it. I skipped through some parts of it.
AUBREY: That's all right. So I could potentially by then be asleep. I might be asleep here in
the studio.
(Soundbite of laughter)
Dr. MOORCROFT: Yeah. Most people, I tell you, once they learn it, they say by about the time
I get down to the small embankment, which is the second of three paragraphs, they're gone.
They're asleep.
AUBREY: Allison Aubrey, NPR News, Washington.
INSKEEP: And that's our health news for this morning.
This is MORNING EDITION from NPR News.
LOAD-DATE: June 21, 2005