London Sleep Congress - 4th and 5th December 2012

London Sleep Congress - 4th and 5th December 2012

I recently attended a two day Congress learning about CBTi (Cognitive Behaviour Therapy (insomnia) for the Management of Chronic Insomnia. Here are just some of the things I have learnt…

There are three main elements to CBTi

The first is Sleep Hygiene: of which the most important things are: 
1. Your bedroom should be as dark as a photographer's darkroom  i.e. very! 
2. Your bedroom could should be kept quite cool in temperature
3. Turn your alarm clock around so you can't see it!

The second element is 'Stimulus Control'
1. Don't do anything in bed apart from sleep (and maybe sex), don't read, eat, watch TV, surf the web in the bedroom. 
2. Try not to 'rest' in bed or 'lie in', if you are awake, get up leave the bedroom and don't go back to bed for at least 30 mins.
3. Only sleep in the bed in your bedroom (so no napping during the day on the sofa!).
4. Go to the bed at the same time each night.

The third element is sleep restriction which is essentially partial sleep deprivation (this is where it gets complicated!)
You calculate your PTTB (PTTB = planned time to bed) based on the time you need to get up and the average amount of sleep you need. 

Your sleep efficiency (SE)  is calculated from the formula TST/TIB x 100% (Time in Bed - Total Sleep Time x 100) 
Total sleep time is equal to the time in bed (TIB - (SL + WASO)) where SL or 'sleep latency' is the time it takes to drop off to sleep and WASO  is 'wake after sleep onset' or the total of the time awake from sleep onset to final awakening. 

e.g. say you spend 10 hours in bed but are actually only asleep for 5.5 hours then your SE or 'sleep efficiency' is 5.5/10 x100 = 55%. Sleep diaries are necessary to record the various parameters…

The fundamental principle of CBTi is Sleep Restriction with the aim of improving sleep efficiency to around 95%, combined with stimulus control and sleep hygiene...

Use sleeping tablets like Zopiclone in ACUTE rather than chronic insomnia, for a minimum 1 - 2 months.

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© Carl Taylor 2012