2024-07-18
한어Русский языкEnglishFrançaisIndonesianSanskrit日本語DeutschPortuguêsΕλληνικάespañolItalianoSuomalainenLatina
For people who suffer from insomnia for a long time, this feeling of wanting to sleep but not being able to sleep is very painful. Not only that, long-term poor sleep will also have a negative impact on physical and mental health.
Some people who often suffer from insomnia rely on sleeping pills to fall asleep, but sleeping pills not only have many side effects, but a considerable proportion of sleeping pills will make people dependent on the drugs after long-term use. In contrast, cognitive behavioral therapy for insomnia is currently the first-line treatment for long-term insomnia, which includes a series of specific treatment methods to change people's sleep behavior, such as stimulus control, sleep restriction, etc. However, from a global perspective, due to limited professional resources, not many people have the opportunity to receive this treatment systematically.
Sleep restriction therapy is to achieve the best sleep effect by gradually adjusting the time spent in bed and improving the actual sleep efficiency. For example, if a person often suffers from insomnia and can only sleep for 6 hours after lying in bed for 8 hours, then limit the sleep time to 6 hours, minus the painful time of 2 hours of insomnia. After the sleep quality gradually improves, the sleep time can be gradually increased every day.
Compared with sleep restriction, stimulus control is also about adjusting sleeping behavior in bed, but it is more flexible. Its special features include principles such as "sleep when you are sleepy" and "get up when you can't sleep", so as to adjust the stimulus control of the bed to a state that is conducive to sleep and avoid painful situations such as "sleeping hard when you can't sleep".
Although these therapies have been available since the 1970s, scientists do not fully understand the efficacy and mechanism of individual specific treatments when cognitive behavioral therapy is widely recommended for insomnia. However, if cognitive behavioral therapy can be simplified, more people will benefit from it.
Recently, a sleep study systematically analyzed the effectiveness of using stimulus control alone to treat insomnia in adults. By combing through relevant scientific evidence from 1972 to 2022, the study showed that using stimulus control therapy alone is also a relatively effective intervention method for improving insomnia.
This study was published in the Journal of Sleep Research in May 2024, providing some scientific evidence for deepening the understanding of stimulus control therapy. The reason why the relevant review started in 1972 is that in that year, Richard R. Bootzin, a professor of clinical psychology at Northwestern University in the United States, published a groundbreaking study in this field.
In this scientific breakthrough, Richard Buzin reports on the treatment of a 25-year-old married man with insomnia whose wife assisted him in implementing several instructions in order to provide better stimulus control for his sleep in the bed and bedroom, the first of which was to lie down to sleep only when he was sleepy.
In addition, do not read or watch TV in the bedroom. If you find yourself lying in bed and unable to fall asleep, get up and stay in another room until you feel sleepy and want to sleep, then go back to the bedroom to sleep. If you still can't fall asleep after lying down again, get up again and stay somewhere else, and repeat this cycle until you get up less and less at night and your sleep quality gets better and better.
The instructions for using these stimulus controls are not set in stone, but have evolved into many different variations. For example, while some scientists support getting up if you can't fall asleep in 10 minutes, some people believe that you should get up only if you can't fall asleep after lying down for 15 or even 20 minutes. At the same time, there is controversy over the mechanism of why this therapy works. In addition, operations such as "getting up if you can't fall asleep" are difficult to stick to. These conflicts also make it difficult to implement related therapies. If more cognitive behavioral therapies are used in the system, the threshold will be higher.
After a comprehensive analysis of the relevant scientific evidence, the latest study also believes that although stimulus control is generally an effective intervention, not all instructions are necessary. "For the average person, implementing stimulus control may be easier than adopting a whole set of cognitive behavioral therapy including sleep restriction therapy. In terms of sleep latency and wakefulness, stimulus control therapy is comparable to other interventions in cognitive behavioral therapy for insomnia. In addition, compared with other interventions, it is even better in improving self-reported total sleep time." Annie Vallières, a professor at the School of Psychology at Laval University in Canada who conducted the study, said that for this method, it is important to maintain a regular sleep schedule and get up if you are awake in bed.
Previously, some studies have found that reading or using electronic devices in bed does not necessarily cause insomnia. For stimulus control treatment, it is more important to control the bedtime, such as sleeping when you are sleepy, avoiding daytime naps, and keeping the waking time consistent every day.
Anne Vallière explained to Southern Weekend that the latest research shows that stimulus control is effective in treating insomnia because it can reduce cognitive activation by diverting the insomniac's attention from the difficulty sleeping. "This means that whether leaving the bed or going to bed just to sleep, it is to prevent people from worrying in bed, or to prevent people from thinking only when they get to bed."
For those who want to go to bed and rest their body and brain, continuing to think about solving the unfinished problems of the day in bed obviously goes against their true intentions. If the worrying problem itself is "why can't I fall asleep", then insomnia will become more complicated, and there may be a vicious cycle between "insomnia" and "thinking about why I can't fall asleep". The role of stimulus control may be to cut off this cycle, keep people away from insomnia anxiety, and make the behavior in bed more focused on sleeping after being tired.
Moreover, it is not just stimulus control. Previously, a trial of sleep restriction therapy by clinical sleep researchers at the University of Oxford showed that short-term sleep restriction through the primary care system can also reduce people's insomnia symptoms. This study was published in The Lancet in 2023, showing that using simple sleep restriction alone to treat insomnia is also effective and cost-effective, and has the potential to be widely implemented in primary care services.
In this clinical trial of more than 600 people, the researchers implemented relevant interventions through nurses who received brief training, mainly introducing information about sleep restriction therapy to insomniacs and asking participants to calculate their sleep efficiency every day to monitor how much time they spent sleeping and how much time they spent awake in bed. In addition to proving that this simple intervention is effective, the study also found that as the degree of insomnia decreased, people's mental health conditions such as depression also improved significantly, and work efficiency also improved.
These studies mean that in addition to the systematic use of cognitive behavioral therapy for insomnia, using only some of them, such as stimulus control or sleep restriction, may also be effective in treating insomnia. More importantly, simplified treatment is more likely to help people get relevant treatment opportunities and increase their means of coping with insomnia.
This clinical response to long-term insomnia, a relatively common and far-reaching symptom, has a positive significance in improving public health efficiency and improving people's overall health level. You know, insomnia does not just mean being tired the next day. There is a lot of scientific evidence that long-term lack of sleep also increases people's risk of depression and may make people more susceptible to dementia in old age. In addition, in the short term, it will also significantly affect people's cardiovascular, immune and metabolic health.
Throughout a person's life, sleep patterns generally differ at different ages due to physical and environmental factors. The sleep duration in the survey statistics is generally divided by the age of 50, first rapidly declines after adulthood, and then rebounds at the age of 60, forming a U-shaped curve. The nearly three decades of low sleep in the middle may reflect the various difficulties faced by adults in the world of work and family pressure. For some people, this may also be part of the reason for their long-term insomnia.
However, when you are under great pressure and have a lot of work to do, what you need most is adequate sleep and rest. Long-term insomnia will undoubtedly make this situation worse. When you can't sleep, worrying about insomnia will not help solve the problem. The latest research on cognitive behavioral therapy for insomnia, such as stimulus control, has played a certain role in promoting the promotion of clinical treatment methods in related fields.
However, it should be pointed out that the latest research also found that when combing through the relevant scientific evidence of the past 50 years, the quality of many studies was not high, which may affect the effectiveness of relevant explanations. The clinical trials of sleep restriction conducted by scientists at the University of Oxford also have limitations such as lack of representative samples, which reflects that research in this field still needs to be strengthened, especially more rigorous clinical studies to evaluate the effects and mechanisms of related therapies, so as to help people better treat insomnia.
In fact, for people who do not suffer from long-term insomnia, some of the intervention principles in these therapies are also of reference value for people to maintain good sleeping habits. For example, stimulus control therapy not only emphasizes "sleep when you are sleepy" and "get up when you can't sleep", but also emphasizes regular work and rest to maintain a healthy biological clock that is conducive to sleep. Within this framework, behaviors such as taking too long a nap during the day are also particularly important to avoid, because they may interfere with normal sleep at night.
In addition, some behaviors that seem to have nothing to do with sleep can actually affect sleep, so you should also pay attention to them. For example, try to avoid doing things that are too stressful and make you emotionally unstable and difficult to calm down before going to bed; according to your personal ability to digest and metabolize alcohol, caffeine, and general food, you should also try to avoid consuming these substances before going to bed to prevent them from interfering with your sleep.
In order to maintain a biological clock that adapts to the circadian rhythm, you can also actively expose yourself to sunlight at regular times during the day, and lower the light brightness at night to reduce exposure to strong light, gradually adapt yourself to the darkness, and prepare for sleep. In short, although insomnia is common, the impact of long-term insomnia is not small and deserves attention. If you have long-term insomnia of unknown cause and are powerless, or if you encounter other rare sleep problems, you should still seek help from a professional doctor in time.
Southern Weekend reporter Wang Jiangtao
Editor: Zhu Liyuan
Collect and organize the latest news information and make it available for free for everyone to read
