Cooling Cap Could Provide Insomnia Relief

There is no easy cure for insomnia. Sleeping pills appear to be a quick fix, but the potential for psychological attachment and rebound insomnia make medication for insomnia a solution for short-term problems only. Alternatively, you can seek cognitive behavioral therapy to help eliminate the harmful thoughts and bad habits that promote extended periods of insomnia. This solution is very effective but also time-consuming and requires effort and dedication.

New research presented at SLEEP 2011, the 25th Anniversary Meeting of the Associated Professional Sleep Societies LLC (APSS), suggests another treatment choice for insomnia may be on the horizon. The potential treatment would use a cooling cap that would lower your brain temperature to help you fall asleep.

Normally, a reduction in brain metabolism occurs as you fall asleep. However, during insomnia, the brain metabolism increases, keeping you awake. The cap helps reduce metabolic activity by cooling the front half of the brain.

The study involved 24 people. Half of the participants had insomnia. Each was subjected to several overnight sleep studies while wearing the cooling cap. The settings for the cooling cap differed each night, ranging from maximum amounts of water cooling to not wearing the cap at all.

Results show patients who wore the cooling cap set to its maximum level slept nearly as well as the subjects who didn’t have insomnia. These findings suggest the device could be a new promising therapy for insomnia sometime in the future. The treatment is still a long ways off; more studies will need to be conducted before the device can hit the marketplace.

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Study Links Sleeping Pills to Mortality

Sleeping pills lengthen your slumber and may shorten your life, a Canadian report claims. The 12-year study linked hypnotic class sleep drugs and anti-anxiety medications with long-term mortality.

Consumption of sleeping pills or anxiety relieving medications was associated with a 36 percent higher death risk, the study concluded. Respondents to a large Canadian National Survey who said they used the medications at least once a month had a mortality rate of 15.7 percent. Those who said did not use the medications had a rate of 10.5 percent. The results were controlled to person risk factors like tobacco use, depression and physical health.

The study offers no clear explanation of the findings. The results bare resemblance to a study published in the September issue of the journal SLEEP that investigated a possible link between insomnia and long-term death risk. It reported five times as many middle-aged male insomnia patients died over the 14-year study length compared with healthy subjects.

Could the elevated mortality rates associated with sleeping pills be due to long-term insomnia? It is not a stretch to conclude a many of the people who regularly use sleeping pills over an extended period of time also have long-term insomnia.

Dr. Geneviève Belleville, the lead author of the sleeping pill study, offers an alternate explanation. Dr. Belleville speculates the sleeping pills and anti-anxiety medications may cause accidents and promote suicides.

Sleeping pills and anxiolytics impact reaction time, alertness and coordination. Under these conditions, the risk of injury from a fall or an automotive accident increases.

A review shows sleeping drugs may increase the risk of suicide as many as seven times over. Central nervous system inhibitors found in the medications may alter a person’s judgment, making some people more likely to carry out suicidal ideations.

The AASM reports hypnotic class drugs are safe and effect short-term solutions to insomnia when used as directed. Go to bed immediately after taking sleep medications and avoid physical activity, driving, or operating heavy machinery. Never take more than the recommended dose, for risk of serious complications.

Dr. Belleville recommends insomnia patients consider the alternative of cognitive behavioral therapy, the most effective solution to long-term insomnia. The approach helps you change actions or thoughts that hurt your ability to sleep and promote a healthy pattern of sleep.

Image by Zach Armstrong

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CPAP for Sleep Apnea Obstructed by Insomnia

A double dose of sleep disorders can disrupt the first option of treatment. Patients who complain of insomnia more often give up on Continuous Positive Airway Treatment (CPAP), researchers at Johns Hopkins University report.

CPAP involves wearing a sealed mask while you sleep. A tube connected to the mask gently blows air into the back of your throat. The sensation may feel unnatural at first. Some patients give up on treatment before they become comfortable with CPAP.

This phenomenon appears to be worse among insomnia patients. People with insomnia may fixate on environmental distractions or sensations like muscle soreness or the urge to urinate while lying awake restlessly. The foreign-feeling CPAP machine might be a big hang-up for this type of insomnia patient.

The study looked at 232 patients’ medical charts at Johns Hopkins Hospital Sleep Disorders Center. Each subject was newly diagnosed with obstructive sleep apnea and prescribed CPAP. Questionnaire data shows 37 percent of participants had at least one form of primary insomnia.

Electronic monitoring data from CPAP shows patients who complained of sleep maintenance insomnia used their device for the fewest overall minutes.

The authors of the study believe more patients may stick with CPAP if their insomnia is first addressed. Cognitive-behavioral therapy is an effective long-term solution to insomnia and may also help CPAP adherence.

The two sleep disorders often coexist and have similar symptoms. A previous study shows 39 to 58 percent of OSA patients have insomnia. Insomnia and sleep apnea can reduce your quality of life, destroy your work productivity and increase your risk of getting in an auto accident.

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“Good Morning America” Dr.: cognitive behavioral therapy better fix for insomnia than sleeping pills

This morning a segment on ABC’s “Good Morning America” explained how cognitive behavioral therapy works and how it helps patients with insomnia.

The first in a series of stories titled “Help Me Fix It”, Dr. Richard Besser emphasized you don’t need pills to get your sleep back on track.



The AASM recognizes cognitive behavioral therapy as the treatment of choice for primary insomnia. Sleeping medications such as Ambien or Lunesta are viewed as an effective temporary solution for short-term insomnia.

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CBS 2’s "Sleep Wreckers" are a few of the common-sense insomnia culprits

On day 2 of WCBS New York City’s “Sleep Week,” health reporter introduced viewers to their so-called “Sleep Wreckers.”

Most elements in their list should be familiar for regular blog readers.

- Pets in bed
-Alcohol before bedtime
-Supplements like B6, B12 or Ginseng in the evening
-Sleep disorders like sleep apnea or restless leg syndrome
-Pain or discomfort while sleeping
-Stress

The report only scratches the surface for behaviors that contribute to sleeplessness. Some are more obvious than others.

-Caffeine after lunch
-Eating before bed
-Exposure to bright light before bedtime
-Heavy evening exercise
-Nicotine before bedtime
-Lengthy naps
-Irregular sleeping patterns
-Using your bed for activities other than sleep
-Uncomfortable sleeping environment

The author of the WCBS article recommends prescription sleep drugs for treating short-term insomnia. The AASM recognizes medications such as Ambien or Lunesta as an effective temporary fix. However, we first suggest improving sleep hygiene and eliminating these “Sleep Wreckers.” Some people may need the assistance of a sleep professional. Cognitive Behavioral Therapy is the treatment of choice for insomnia. Patients work with behavioral sleep experts to change the thoughts and actions that contributed to difficulty sleeping.

Learn more about Cognitive Behavioral Therapy on Sleepeducation.com.

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Chronic Pain: Cognitive Behavioral Therapy Improves Sleep

A new study found that cognitive behavioral therapy (CBT) can significantly improve sleep for people with chronic neck or back pain.

Many people living with chronic pain have poor sleep hygiene. Common mistakes include sleeping when they are not tired, sleeping in places other than the bedroom and watching TV in bed. These habits may lead to insomnia.

People taking medicine for their pain may be unwilling or unable to use sleep aids to treat their sleep problems. CBT provides a safe and effective alternative.

The study involved 28 people who experience chronic pain. Participants received eight weeks of therapy from a trained nurse therapist.

Therapy sessions established a set number of hours in bed, focused on negative thoughts about sleep and addressed unhealthy sleep behavior. Sleep diaries were used to track sleep. Pain and mood were measured throughout the study. Patients were followed for six months after treatment.

Patients who are interested in CBT but have limited access to face-to-face sessions can receive treatment online. Last year the Sleep Education Blog reported that online CBT programs have the potential to provide long-lasting effects for people who suffer from chronic insomnia.

The AASM recommends CBT as an effective treatment for chronic insomnia in adults. Consult a board-certified sleep expert at an AASM-accredited sleep center if you are suffering from an ongoing sleep problem.

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How Does Yoga Help You Sleep?

Yesterday the Globe and Mail examined how yoga helps you sleep.

Harvard assistant professor Sat Bir Khalsa, PhD, told the Globe and Mail that yoga helps reduce the stress that can hinder sleep.

“With time and practice, the stress system begins to quiet down,” he said.

What changes occur in the body during yoga? The NCCAM reports that it is unclear. But there is growing evidence that yoga enhances stress-coping mechanisms.

One study by Khalsa used yoga to help people with chronic insomnia. They had one in-person training session. Then they practiced yoga on their own for eight weeks. They also had brief follow-ups by phone and in person.

Results show that sleep improved in 20 people who completed the study. They fell asleep faster and slept longer.

A review he published found that most yoga research has been conducted and published in India. But researchers in the U.S. and England are starting to conduct more studies.

A yoga instructor also explained to the Globe and Mail that bedtime yoga is easy and convenient. She practices yoga techniques while in bed in her pajamas.

“It’s not a magic button,” she said. “But I know that I’m not just lying down there and tossing and turning – I’m restoring my body.”

The article also described the iRest program. It involves a form of yoga called “yoga nidra.” It reduces stress and promotes deep relaxation.

In 2006 the U.S. Department of Defense began testing the iRest protocol. It has been used to help soldiers who have PTSD.

Learn more about sleep and yoga. Read more about insomnia.

There are a variety of cognitive and behavioral methods that are effective for treating insomnia. Learn more about cognitive behavioral therapy on SleepEducation.com.

Image courtesy of the National Institute on Aging

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Can Yoga Help You Sleep Better?

The show eightWest on WOOD TV8 in Grand Rapids, Mich., did a feature on “Yoga for Better Sleep.” The five-minute segment shows some yoga moves that can help you relax for bedtime.



So can yoga really help you sleep better?

Last year the Sleep Education Blog reported on a small study from Northwestern University. It involved 11 adults with chronic primary insomnia. Sleep improved for those who practiced yoga and meditation for two months.

A recent study from India evaluated “cyclic meditation.” This technique combines yoga postures with periods of lying down on your back to rest.

Thirty men practiced cyclic meditation twice during the same day. On another day they had two sessions of rest without the yoga postures.

The study found that the men had more deep, slow-wave sleep after cyclic meditation. They also had fewer awakenings. And they felt that their sleep was more refreshing.

There are a variety of cognitive and behavioral methods that are effective for treating insomnia. Learn more about cognitive behavioral therapy on SleepEducation.com.

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Changing Nightmares: Imagery Rehearsal Therapy

“Your Health” columnist Kim Painter reports in USA Today that imagery rehearsal therapy is helping some people change their nightmares.

This method is just one form of cognitive behavioral therapy. A variety of CBT techniques have been used to reduce nightmare frequency.

One method is to record your nightmares in a diary. Relaxation exercises also may be helpful. Exposure techniques involve “reliving” a nightmare in your imagination during the daytime.

Cognitive-restructuring techniques involve changing a nightmare. One technique is lucid dreaming treatment; you change the nightmare as it occurs during sleep.

Imagery rehearsal therapy involves changing the nightmare while awake; you “rehearse” the new version in your mind during the day.

The first step is to write down a recent nightmare. Then you change the nightmare. Usually you change it to a more positive version.

You write down this new version. Then you rehearse it in your mind daily; you imagine the imagery of the changed nightmare.

In 2008 a review in the Journal of Clinical Sleep Medicine noted that CBT has become the treatment of choice for nightmares. It reported that imagery rehearsal therapy and exposure are effective at reducing nightmares; the methods also reduce other sleep complaints and mental distress.

The authors noted that the drug prazosin also may be effective at reducing nightmares. But it appears that treatment requires ongoing use of the drug; nightmares may return after drug withdrawal.

One of the review’s co-authors was sleep specialist Dr. Barry Krakow. He is founder of the Maimonides International Nightmare Treatment Center in Albuquerque, N.M.

In 1992 Krakow and colleagues at the University of New Mexico published a study of imagery rehearsal therapy in the journal Sleep. They found that the therapy reduced nightmare frequency by 72 percent.

Nightmare rehearsal was first reported as an effective treatment option in a 1978 case study. The method was adapted into an imagery rehearsal technique at the University of New Mexico; the first case studies were reported in 1991.

In June the Sleep Education Blog reported that imagery rehearsal therapy also can be helpful for children with nightmares. Learn more about dreams and nightmares on SleepEducation.com. Get help for nightmare disorder at an AASM-accredited sleep center near you.

Image by Cornelia Kopp

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Biofeedback to Treat Insomnia

A recent article from Health magazine describes the use of “biofeedback” to treat insomnia.

What’s biofeedback? It’s a form of therapy that gives you visual or auditory feedback for certain body signals.

Cues may give you details about your heart rate, blood pressure, breathing or body temperature. Then you learn to control the body in a way that promotes sleep.

Author Leslie Goldman describes how for eight years she struggled with sleep. Then she gave biofeedback a try.

“The change has been dramatic,” she writes. “After nearly a decade of sleeping for no longer than two hours at a time, I can sleep for four hours straight and doze off again after I wake up.”

The AASM recommends biofeedback as an effective treatment for chronic insomnia.

Often biofeedback will be combined with other treatment methods. This is called cognitive behavioral therapy, or CBT.

CBT is a safe and effective treatment option for people who are struggling with ongoing insomnia. It uses a variety of methods to help you develop positive attitudes and habits that promote a healthy pattern of sleep.

Learn more about how CBT for insomnia is safe and effective. Get help for insomnia at an AASM-accredited sleep disorders center near you.

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