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Cognitive behavioral therapy for insomnia (CBTI) as an alternative to sleeping pills | Matt Walker

January 24, 2020

[Matt]: We know that sleeping pills are associated
with a markedly higher risk of death, as well as cancer, as well as your susceptibility
to infection, particularly in pneumonia. But returning to alcohol, it is definitely
one of the most, I think, misunderstood drugs. But what I was saying regarding THC, alcohol,
sleeping pills, if you are using anything to help you sleep, I think you have to ask
yourself, are you just really treating, you know, an open wound and not really actually
trying to stitch it up? Because what that is simply doing is masking
a problem that you’re not dealing with, you know. Why is it, like…? And this is not a criticism, I’m sorry if
my voice sounds like that, and it’s not, you know, I’m so sympathetic to people who have
sleep problems. We see them all of the time here. But you have to ask why. Why is it that you’re struggling with sleep? Is it because you’re of a certain chronotype
and you don’t understand your chronotype and you’re sleeping at the wrong phase of the
24-hour period and it’s masquerading as insomnia. Or do you have too much anxiety in your life
and you’re blunting that anxiety with things like alcohol or THC or sleeping pills? You know, you’re just kicking the can down
the road. You’re just hitting the mute button. But the movie is still playing of damage. Whatever is causing that sleep disruption,
you know, is still there. You’re just sedating your brain and trying
to mask it. So I think people who are using those things,
if they’re having sleep difficulties, you should ask yourself, could I examine my life
and really think more about what it is that is preventing me from sleeping. What’s good is that you don’t have to turn
to any of those because there is a non-pharmacological treatment but is just as effective as sleeping
pills in the short-term. It is completely safe. And it is more efficacious in the long-term. And it’s called cognitive behavioral therapy
for insomnia or CBTI. Based on its efficacious nature, and they’ve
been done lots of randomized clinical control trials, it is just as powerful as sleeping
pills in the short-term. But when you stop working with your therapist,
and you work with a therapist for several sessions across several weeks, when you stop
working with a therapist, you don’t go back to the bad sleep that you have. You continue on with your good sleep. Unlike sleeping pills, which is when you stop
them, you have what we call rebound insomnia, which is that you tend to go back to the bad
sleep that you are having, if not worse sleep that you are having before you started taking
sleeping pills. And the danger surround sleeping pills and
their lack of true benefit above and beyond placebo, which is, if you look at these meta
analyses, in 2015 or 2016, the American College of Physicians made a landmark recommendation. They said that sleeping pills must no longer
be the first line recommended treatment for insomnia. It must be cognitive behavioral therapy for
insomnia because of both the deleterious, deathly, and carcinogenic consequences of…or
association with…I shouldn’t say cause because we don’t yet know cause. But certainly they are associated with higher
mortality risk and higher cancer rates. CBTI, this cognitive behavioral therapy, must
be the first-line recommendation treatment.


  • Reply FMF Clips February 28, 2019 at 3:56 pm

    Watch the full episode:

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  • Reply Аha Pob May 5, 2019 at 8:50 pm

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  • Reply Republi Traitors November 1, 2019 at 5:04 pm

    CBT-I is effective ONLY when dealing with suitable patients ie, where a patient has insomnia caused by factors that CBT-I deals with. In others it is futile & a lot of doctors are confused & even confrontational when faced with a patient who sits there telling them that it doesn't work for them. Even explaining the clear reasons WHY it's not working gets you nowhere. CBT-I is the latest Cure-All fad, those who's insomnia have different causes are left without treatment because no one offers anything else, they've all climbed on the CBT-I Band Waggon.

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  • Reply AS W December 3, 2019 at 5:43 pm


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