COGNITIVE BEHAVIORAL THERAPY – A SOLUTION FOR SLEEPLESS NIGHTS
How important is sleep in your overall health and well-being? Do you feel it is pointless wasting so many hours sleeping and there is nothing fruitful happening ?
Sleep is a very essential component which has its own gravity in your daily schedule. It has different stages one of which is called REM(rapid eye movement), this is a stage where you get dreams and also your brain is most active. A sound sleep helps a person to enter this stage, thus stimulating the areas of your brain that are essential in learning and making or retaining memories. Good sleep also leads to more creative thinking, organizing new information and mental well being. So it has a considerable role in normal individuals as well as in Parkinson’s patient’s lives.
Now Parkinson’s disease is not just found to have motor symptoms, but also has a major non motor symptoms one of which is sleep. Several Parkinson’s patients are suffering with sleep issues. Around 96% of PD patients were reported to have sleep issues, which amounts to a very significant number of Patients.
There are several causes for such a huge number, it might be due to stress, anxiety , depression which makes it difficult for them to fall asleep(insomnia). The sleep might also be disturbed with frequent awakening because of the urge to urinate(nocturia), vivid dreams, hallucinations, other motor complications like difficulty while moving in bed, pain, cramps and rigidity. With disturbed sleep patients face daytime drowsiness , energy levels are low which leads to less productive day. Research states that patients who had sound sleep reported to have less motor symptoms, less fatigue levels in the morning. This was termed as “sleep benefit”. A study concluded the average duration of “sleep benefit” to last around 86 minutes once they are awake. Any patient will be definitely benefited by this as they can perform their early morning activities with ease. Even after having the first dose of medication in the morning it takes time to start its effects. I feel having proper sound sleep will help patients to alleviate these problems. Currently pharmacological treatment for sleep problems is being practiced majorly, which sadly has its own side effects. So Why not try some non-pharmacological approach?
I came across COGNITIVE BEHAVIOURAL THERAPY which has proven to be very promising in treating Parkinson’s patients with sleep issues. Specially in cases of insomnia or frequent awakening. Patients who received cognitive behavioral therapy for insomnia(CBT-I) have reported better quality of life and motor symptoms. This therapy helps to stimulate the sleep drive which makes it easy for a person to fall asleep plus it normalizes the sleep-wake cycle and circadian rhythm . It works on two major components BEHAVIORAL AND COGNITIVE which in simple words means the process of thinking both in context to sleep. The BEHAVIORAL part works on two major theories STIMULUS CONTROL and SLEEP RESTRICTION. The COGNITION part works on how a thought process can impact on a person’s sleep. CBT-I can be received one on one with a certified therapist or through online consultation. Even various online courses to learn CBT- I have been introduced recently. I did one of them and found it to be very useful. So why not opt for a different approach which will save you from popping pills and also from those dreadful nights which you spent just twisting and turning in bed thinking why can’t I get sleep. I feel you should definitely go for it to have a better kick start to your mornings!!!
REFERENCES:
- Rachel Manber, Ph.D. Leah Friedman, Ph.D, Cognitive Behavioral Therapy for Insomnia in Veterans. Therapist manual
- Dereje Melka,Prevalence of sleep disorders in Parkinson’s disease patients in two neurology referral hospitals in Ethiopia,BMC Neurology volume 19, Article number: 205 (2019)
- Meghan Humbert, Cognitive behavioral therapy for insomnia in Parkinson’s disease: a case series,Published in partnership with the Parkinson’s Disease Foundation,2017.
- D E Bateman, Sleep benefits in parkinson’s disease, Journal of neurology, neurosurgery and psychiatry, Volume 67, Issue 3
- Chihaya Osawa,Brief Cognitive Behavioral Therapy for Insomnia in Parkinson’s Disease: A Case Series Study,15 April 2020,jpr.12287
- Ann Indian Acad Neurol. Sleep disorders in Parkinson’s disease: Diagnosis and management,2011 Jul; 14(Suppl1): S18–S20.
- Andreas Charidimou,The Role of Cognitive-Behavioural Therapy for Patients with Depression in Parkinson’s Disease,Volume 2011 |Article ID 737523
- Jade Q,Cognitive Behavioral Therapy for Insomnia Comorbid With Psychiatric and Medical Conditions A Meta-analysis , September 2015 Volume 175, Number 9
- Shnehal Patel, A Computerized Cognitive behavioral therapy Randomized, Controlled, pilot trial for insomnia in Parkinson Disease,Journal of Clinical Movement Disorders (2017) 4:16
- S. Coe Physical Activity, Fatigue, and Sleep in People with Parkinson’s Disease: A Secondary per Protocol Analysis from an Intervention Trial,Volume 2018 |Article ID 1517807
- Giovanna Calandra-Buonaura,Rotigotine Objectively Improves Sleep in Parkinson’s Disease: An Open-Label Pilot Study with Actigraphic Recording, Volume 2016 Article ID 3724148
- Meghan Humbert,Cognitive behavioral therapy for insomnia in Parkinson’s disease: a case series, 2017 Jul 28.