Australasian Sleep Association position statement regarding the use of psychological/behavioral treatments in the management of insomnia in adults

Sleep Med. 2017 Aug;36 Suppl 1:S43-S47. doi: 10.1016/j.sleep.2017.03.017.

Abstract

Insomnia disorder is a high prevalence condition with a high disease burden, which, left untreated, can increase risk of poorer health outcomes. Due to Insomnia's tendency towards having a chronic course, long-term treatment approaches are required to reduce the impact of Insomnia over time. After reviewing the available literature, The Australasian Sleep Association (ASA) recommends Cognitive Behavior Therapy for Insomnia (CBT-I) as a first line treatment in the management of Insomnia. The ASA notes that in addition to CBT-I, there is emerging evidence for the use of Mindfulness Based Therapy for Insomnia when used in combination with behavioural techniques (MBT-I). CBT-I should be used whenever possible, and medications should be limited to the lowest necessary dose and shortest necessary duration. CBT-I, whilst the most effective long-term treatment, does not work for everybody across all circumstances, so there will be circumstances in which other treatments are required (e.g., pharmacotherapy). Improving access to CBT-I is an important issue which will involve raising awareness of the effectiveness of CBT-I, increasing the number of trained practitioners, and the development of effective low intensity treatments that can be offered in the first instance.

Keywords: Cognitive Behaviour Therapy-Insomnia; Insomnia; Treatment effectiveness; Treatment guidelines.

MeSH terms

  • Adult
  • Australasia / epidemiology
  • Awareness
  • Cognitive Behavioral Therapy / methods*
  • Combined Modality Therapy / methods*
  • Cost of Illness
  • Female
  • Humans
  • Male
  • Mindfulness / methods
  • Prevalence
  • Sleep Initiation and Maintenance Disorders / classification
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Sleep Initiation and Maintenance Disorders / psychology*
  • Sleep Initiation and Maintenance Disorders / therapy
  • Stress, Psychological
  • Treatment Outcome