By Dr. Jean-Jacques Dugoua, ND

Our habits, good or bad, affect our quality of life and our health. As we age and become set in our ways, we may pick up some less-than-desirable health habits, particularly when it comes to sleep.

Insomnia in older adults and the elderly is increasingly common. Insomnia can be treated with medication or with supplements, but it may also be treated through behavioral and cognitive therapy. Behavioral therapy addresses our behavior, while cognitive therapy addresses the mental processes of knowing, thinking, learning and judging. Researchers have found that behavioral and cognitive therapy may have some success in treating insomnia.

A study was conducted on 78 adults (50 women and 28 men with an average age of 65 years) with insomnia. The purpose of the study was to evaluate the clinical effectiveness of behavioral therapy and medication, alone and combined, for late-life insomnia. Subjects were divided into groups where they received behavioral and cognitive therapy (changing sleeping habits), or medication, or behavioral and cognitive therapy and medication, or no treatment (placebo). Through sleep diaries and polysomnography (an instrument that measures physiological activity during sleep), the time taken to fall asleep was measured for all subjects.

The results of this study indicated that subjects receiving behavioral and cognitive therapy and medication fell asleep fastest and suffered less insomnia. The results also indicated that subjects using behavioral and cognitive therapy alone fell asleep faster than subjects using medication alone. Once therapy and medication were discontinued, subjects that had received behavioral and cognitive therapy had fewer relapses of insomnia than subjects that had only taken medication. The study concluded that behavioral and cognitive modifications had the best results for long-term sleep improvement in people with insomnia.

Some behavioral and cognitive techniques used in this study are outlined below:

1. Restrict time in bed to sleep time. e.g., if you only sleep six hours per night, do not lie in bed for eight hours.

2. Go to bed only when you feel sleepy.

3. Use the bed and bedroom only for sleep and sex (i.e. no reading, TV watching or worrying in bed or the bedroom during the daytime or at night).

4. Get out of bed and go to another room if you are unable to fall asleep within 15 to 20 minutes.

5. Repeat item #4 as often as necessary, either when trying to fall asleep or get back to sleep.

6. Rise at the same time every morning regardless of the amount of sleep you got the previous night.

7. Avoid daytime napping. If a nap is needed, limit it to less than 1 hour and nap before 3 pm.

8. Exercise.

9. Eat a healthy, well-balanced diet.

10. Avoid stimulants such as coffee, tea, chocolate and tobacco.

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