Psychology Treatment for Sleep Problems by hhmueller


									The Importance of a Good Night’s Sleep
More and better quality sleep would make most people happier, healthier, and safer. But getting a good night’s sleep is largely dependent on good psychological and physical health. Stress, anxiety, and depression almost inevitably interfere with sleep, as do pain and a number of other medical conditions. Chronic sleep disturbance can also increase the risk for major depression and other mental illness as well as lower immune function. Research has also shown an association between chronic sleep deprivation and increased body weight and insulin resistance leading to Type 2 diabetes as well as high blood pressure and cardiovascular disease. Lack of sleep is also a leading cause of injury and death due to motor vehicle and work-place accidents. Conversely, sleep may play a protective role against infectious diseases and may even speed up recovery from some illnesses. But getting a good night’s sleep can be an almost insurmontable problem for the estimated 10% to 15% of the population who suffer from chronic insomnia and other sleep disorders. Or the 40% to 60% of adults reporting sleep problems a couple of nights a week or more. Or the majority of teenagers who are chronically sleep deprived. Current research suggests that a majority of Canadians do not get enough sleep or a quality of sleep adequate for optimum health and well-being. We have become a nation of sleep-deprived insomniacs routinely using prescribed and OTC medications to get to sleep at night and various stimulants to keep ourselves awake during the day.

years. When individuals with persistent insomnia are asked about the types of methods they have used to cope with insomnia, the majority report passive strategies such as reading, listening to music or watching television, staying up late until they are tired or spending more time in bed. The first line of active treatment usually involves self-help remedies such as alcohol, over-the-counter products, or herbal/dietary supplements. When all these strategies have failed, some individuals will seek professional help. As for most other health conditions, most individuals with insomnia typically seek treatment, not from a psychologist, but from their primary care physician first, and treatment almost always involves drug therapy. Over 50% of patients consulting for insomnia in medical practice are prescribed a hypnotic (i.e., sleep medication) and the majority of those continue using their medications almost daily for more than a year. Most of the remaining patients are pre-scribed antidepressant or antianxiety medications. Sadly, while there is good evidence that most of these hypnotic medications are effective in reducing the amount of time it takes to get to sleep and number of awakenings during the night in the short-term, the long-term efficacy and safety of these drugs remains unknown. As well, many hypnotic drugs have effects on the different stages of sleep that will result in reduced sleep quality and nonrestorative sleep.

anxiety and panic attacks, eating disorders and substance abuse. Now, CBT has also proved effective against insomnia. So effective, in fact, that for most people CBT works better than sleeping pills— without side-effects. Research studies indicate that between 70% to 80% of persons treated for insomnia with CBT will obtain substantial benefits from treatment that will maintain and often increase over time. Cognitive behavioral thera-py (CBT) is based on the idea that how a person thinks affects the way they feel and behave. CBT helps to improve sleep by helping the patient identify and change the thoughts, attitudes, beliefs, and behaviors that interfere with getting a good night’s sleep. For example, the beliefs that it is absolutely essential to get at least eight hours of uninterrupted sleep every night, or that you simply cannot function at work on less than eight hours of interrupted sleep, or that it is best to stay up at night until you are really tired before going to bed, are all too common but unhelpful in getting you to sleep. CBT helps you identify and change such unhelpful personal beliefs and attitudes. Similarly, CBT can help you identify habitual ways of thinking about day-to-day problems that only increase your stress and prevent sleep. CBT can also help you to better cope with and manage your stress. CBT is also a very effective treatment for depression and anxiety which may be preventing sleep.

Getting a Good Night’s Sleep With the Help of Psychology
Psychologists can offer a number of effective therapies for insomnia, including sleep hygiene counselling, behavioral and cognitive therapies, relaxation training, and biofeedback.

Relaxation Training
Relaxation is the most commonly used nondrug therapy for insomnia. But many people simply do not know how to relax properly. Relaxation training focuses on teaching how to relax both the mind and body, which helps reduce any anxiety or tension that may interfere with sleep onset. Effective relaxation methods can be used both during the day to reduce stress effects and at bedtime to help with sleep. This type of training involves teaching patients to better control the following functions… muscle tension, heart rate, breathing, and mental focusing.

Despite its high prevalence and negative impact, insomnia remains for the most part untreated. Surveys reveal that less than a quarter of those experiencing serious insomnia have used either a prescribed or over-the-counter sleep aid within the previous year and the average duration of insomnia before seeking professional help often exceeds 10

Cognitive Behavioral Therapy
There is an effective alternative to pills for treating insomnia, even severe and chronic insomnia. Called cognitive behavior therapy (CBT), this relatively simple, short-term psychotherapy has long been used successfully to treat a range of problems, including depression, generalized

Biofeedback Training
Often used together with relaxation training, biofeedback uses specialized electronic instrumentation to monitor physiological processes such as heart rate, breath rate, blood pressure, body temperature, sweat gland activity, muscle tension, brain waves, etc. and teach individuals how to gain voluntary control over these processes. Through biofeedback it is possible to learn to effectively reduce the autonomic nervous system arousal (ie., flight or fight response) that occurs in response to stress or anxiety and interferes with sleep onset.

Alberta, Association for Applied Psychophysiology & Biofeedback, International Society for Neurofeedback & Research, and Multidisciplinary Association for the Study of Cranio-Cervical Pain. Dr. Mueller has over 30 years of experience working as a clinical psychologist in psychiatric, general and rehabilitation hospital settings, community mental health clinics, and private practice settings treating both children and adults. Dr. Mueller’s treatment approach is primarily cognitivebehavioral and psychophysiological; emphasizing the complex interconnectedness of mind and body. His clients encompass a wide age range, from pre-teens to seniors, with a broad range of health problems. Cost. Psychological and biofeedback therapies are not covered by Alberta Health Care Insurance but are frequently covered by private group or individual extended health care insurance plans. In certain cases, WCB or motor vehicles insurance will pay the costs of psychological treatment. Dr. Mueller offers free initial consultations and a sliding fee scale for uninsured individuals who cannot afford his standard fees.

Psychological Treatment of Insomnia

Sleep Hygiene Counselling
Sleep hygiene counselling is concerned with educating the patient about health practices (e.g., diet, exercise, caffeine use, etc.) and environmental factors (e.g., light, noise, temperature, etc.) that may interfere with sleep. Although these factors are rarely of sufficient severity to be the primary cause of insomnia, many people experiencing insomnia engage in poor sleep hygiene practices that increase their problems with getting a good night’s sleep.

For more information, or to make a referral or an appointment, contact:

Who is Dr. Horst Mueller?
Dr. Horst Mueller is an Albertaregistered psychologist (College of Alberta Psychologists #1290) with special interests in clinical health psychology and applied psychophysiology and biofeedback. He is listed with the Canadian Register of Health Service Providers in Psychology (CRHSPP) and is a Diplomate-Fellow of the Biofeedback Certification Institute of America (BCIA) and the Prescribing Psycologists’ Register (PPR). He holds board certifications in both biofeedback and psychopharmacology and is affiliated with a number of voluntary professional associations, including the Psychologists’ Association of Alberta, Canadian Psychological Association, Canadian Pain Society, Pain Society of

Dr. Horst H. Mueller

Dr. Horst H. Mueller
Registered Psychologist
Green Apple Health Care #221, 9148-23 Avenue Edmonton, Alberta T6J 6L7
Tel: 780-485-9468 Fax: 780-485-3587 Toll-Free VM: 1-866-202-4355
Email: URL:

Private Practice Clinical & Health Psychology

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