The role of CBT in addressing insomnia

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There is a wealth of evidence to suggest that cognitive behavioural therapy (CBT) is an effective treatment for insomnia. Prof Marcantonio Spada looks at the role that occupational health professionals have in promoting and facilitating access to this treatment.
Disturbed sleep, ranging from mild to severe insomnia, is and has always been a common problem. When insomnia first emerges – which can be a consequence of a physical or psychological condition (for example, anxiety or low mood) – it can quickly escalate, as individuals will tend to start worrying about the impact it will have on performance, particularly at work.
Some may take short-term measures to “normalise” the initial sleep disturbance (or mild insomnia in many cases) and to cope with emerging worries. This may include the use of alcohol, benzodiazepines (for example, Xanax) and sleeping pills (for example, Zopiclone). These forms of self-medication will eventually lead to an exacerbation of insomnia as they negatively affect sleep “architecture”. Discontinuing the use of alcohol and benzodiazepines will also cause, for many, a rebound in insomnia and a possible worsening of insomnia.
Good sleep hygiene is vital for the performance of all workers, but especially for those in safety-critical roles, where disturbed sleep can pose a danger.
Occupational health professionals have a role in educating staff about insomnia and how to tackle it. For example, they may consider presenting a series of tips to help employees manage insomnia in a more effective manner. Education on sleep hygiene, particularly surrounding the use of technology close to bedtime, is crucial, as are reduction in alcohol use and the increase in physical activity during the day. Sleep restriction principles, improving the sleep environment, and relaxation training and techniques can also be of great help.