Week 3 - Key reading

Question 1

Espie 2007

Answer 1

• Psychophysiological insomnia is most common form of persistent primary insomnia
  
  • Behavioural phenotype
  • Can be treated effectively using a range of psychological interventions
  • Behavioural and cognitive factors play a role
  • Explanatory model called the attention-intention-effort pathway
    ○ Sleep normalcy is an automatic process
    § May be inhibited by focused attentions and direct attempts to control its expression

Question 2

Kyle 2010

Answer 2

• Insomnia is a 24h disorder impairing important aspects of daytime functioning
  
  • Little published work describing the impact of insomnia on important areas of functioning or the experience of living with chronically disturbed sleep on a daily basis
  • Ppts described daily difficulties with cognitive, emotional, and physical functioning which had a cumulative effect of reducing work performance and social participation as well as limiting life aspirations
  • Also described feeling isolated which was precipitated by a lack of understanding from others and experiences with health care providers
  • Chronically disturbed sleep can seriously limit overall quality of life.

Question 3

Morin

Answer 3

• Psychological and behavioural factors play an important role in insomnia
  
  • Psychological and behavioural therapies produced reliable changes in several sleep parameters of individuals with primary insomnia or insomnia related with medical and psychiatric disorders
  • Sleep improvements achieved with treatment were well sustained over time expect in reduced psychological symptoms/distress
  • 5 treatments met criteria for empirically supported psychological treatments for insomnia: stimulus control therapy, relaxation, paradoxical intention, sleep restriction, cognitive behaviour therapy

Question 4

NIH

Answer 4

• Chronic insomnia is a major public health problem affecting millions of individuals, along with their families and communities.
  
  • Little is known about the mechanisms, causes, clinical course, comorbidities, and consequences of chronic insomnia.
  • Evidence supports the efficacy of cognitive-behavioral therapy and benzodiazepine receptor agonists in the treatment of this disorder.
  • Very little evidence supports the efficacy of other treatments, despite their widespread use.
  • mismatch between the potential lifelong nature of this illness and the longest clinical trials, which have lasted 1 year or less.