Section Authors: Lee M. Ritterband and Elise M. Clerkin* (University of Virginia)
Insomnia involves a subjective complaint of problems initiating and/or maintaining sleep, or nonrestorative sleep. There are four main types of sleep problems that can occur in the context of insomnia: 1) Sleep Onset (difficulty falling asleep); 2) Sleep Maintenance (wakening during the night and having difficulty falling back to sleep); 3) Terminal Early Awakening (waking early in the morning and being unable to fall back to sleep); and 4) Mixed Sleep Problems (combination of difficulties initiating and sustaining sleep). Insomnia is associated with a range of problems, including clinically significant impairment or distress in social, occupational, and other important areas of functioning.
Although Cognitive Behavior Therapy (CBT) is widley regarded as one of the most effective treatments for insomnia, some of CBT’s component techniques are also independent treatments for insomnia (e.g., Sleep Restriction, Stimulus Control, etc.). As of yet, there has not been a complete dismanteling of CBT to isolate the relative efficacy of each component within the same study. Therefore, we have included research status information for CBT generally, as well as research status information for some of the techniques comprising CBT.
- Cognitive Behavior Therapy (strong research support)
- Sleep Restriction Therapy (strong research support)
- Stimulus Control Therapy (strong research support)
- Relaxation Training (strong research support)
- Paradoxical Intention (strong research support)
- Electromyograph (EMG) Biofeedback (modest research support)
- Accredited Sleep Disorders Centers (http://www.sleepcenters.org/)
- American Academy of Sleep Medicines (http://www.aasmnet.org/)
- National Sleep Foundation (http://www.sleepfoundation.org/)
- Sleep Net (http://www.sleepnet.com/)
- Sleep Research Society (http://www.sleepresearchsociety.org/)
The Sleep Research Society Trainee Manual provides a variety of resources on training opportunities in basic clinical sleep research and sleep medicine. To access all trainee resources, click on ‘Show All Trainee Programs’ from the following link: http://www.sleepresearchsociety.org/TraineeManual/index.aspx
We want to thank Dr. Charles Morin for allowing us to pull from his excellent review article of psychological and behavioral treatment of insomnia:
- Morin, C., Bootzin, R., Buysse, D., Edinger, J., Espie, C., & Lichstein, K. (2006). Psychological and behavioral treatment of insomnia: Update of the recent evidence (1998-2004). Sleep, 29, 1398-1414.
Note: Other psychological treatments may also be effective in treating Borderline Personality Disorder, but they have not been evaluated with the same scientific rigor as the treatments above. Many medications may also be helpful for Borderline Personality Disorder, but we do not cover medications in this website. Of course, we recommend a consultation with a mental health professional for an accurate diagnosis and discussion of various treatment options. When you meet with a professional, be sure to work together to establish clear treatment goals and to monitor progress toward those goals. Feel free to print this information and take it with you to discuss your treatment plan with your therapist.
* Based on effort and expertise, both Lee Ritterband and Elise Clerkin should be considered to share first authorship for this section on Insomnia.