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With school winding down for both crazy-busy, stressed-out high school and college students, summer vacation proves to be a great time to set up healthy sleep habits. Whether you're an insomniac who regularly watches 3 a.m. infomercials or simply a young adult with crazy sleep habits, we all can benefit from catching some extra zzz's. In fact, the National Institutes of Health (NIH) suggests that 60 million Americans suffer chronic insomnia yearly.
That's why Campus Calm decided to speak with Dr. Gregg Jacobs about a drug-free online therapy for chronic insomnia sufferers called cognitive-behavioral therapy. Dr. Jacobs is an Insomnia specialist at the University of Massachusetts Memorial Medical Center and founder of www.cbtforinsomnia.com.
As a Senior Scientist at Harvard's Mind/Body Medical Institute and an Assistant Professor of Psychiatry at Harvard Medical School, where he spent almost 20 years treating and researching insomnia, he developed the first drug-free program for insomnia proven to be more effective than sleeping pills. His insomnia research at Harvard Medical School was funded by the National Institutes of Health and published in journals such as the Archives of Internal Medicine. Dr. Jacobs is also the author of Say Good Night to Insomnia (New York: Henry Holt).
Maria: What is cognitive-behavioral therapy and how do you apply it to the treatment of insomnia?
A: CBT is a non-drug approach to improving sleep that aims at changing sleep behaviors, changing thoughts about sleep, improving relaxation skills, and improving lifestyle habits that affect sleep. It is based on the idea that insomnia is due to learned thoughts and behaviors that can be unlearned. It is applied as a 5 week, 5-session program by most clinicians. However, there are fewer than 200 clinicians in the United States with expertise in this area. This is why I have made my CBT available on my website www.cbtforinsomnia.com as an interactive, web-based program.
Maria: When I experienced chronic insomnia a few years ago, I could feel myself becoming anxious as evening approached, because I would fear another sleepless night. I could feel my heart beat faster as the sun began to set and a few times, I found myself having panic attacks before bed. Of course I didn't sleep well, if at all. I would experience racing thoughts, toss and turn, cry and punch my pillow. How can a person break this cycle of sleep anxiety?
A: CBT utilizes techniques that change negative, anxious, untrue thoughts about sleep (called cognitive restructuring techniques), techniques to increase sleep drive so that you are too drowsy to be anxious, and relaxation techniques.
Maria: When college students sleep irregularly, napping for hours in the afternoon, partying all night on the weekends, does this set up the body for sleep problems long term? Why or why not?
A: It can in students who have a tendency toward sleep problems because irregular arising times create a chronic jet lag that disrupts the brain's sleep rhythm. Napping can also disrupt sleep that night.
Maria: What is considered a healthy amount of sleep for a college student to aim for on a nightly basis?
A: Sleep needs vary from person to person, although most adults need six to eight hours, with the average being seven.
Maria: Can a lack of sleep be a cause of student anxiety and depression or is it the other way around?
A: It can work both ways.
Maria: Many college students abuse caffeine and other drugs for an energy boost to make it through the day as they work to complete double majors, a laundry list of extracurriculars, internships and outside employment. These same kids later pop sleeping pills or abuse alcohol to unwind at night or shut their minds off. Would it be fair of me to observe that college has become a microcosm of America's workaholic culture that rewards overachieving without even looking at the toll stress takes on the body and minds of our young people ... and adults as well?
A: Yes- and using caffeine during the day and then sleeping pills or alcohol at night not only sets up a chronic cycle of disrupted sleep that can persist for years but alcohol and sleeping pills have risk and side effects that are unhealthy and that can lead to addiction.
Maria: If students can't find the time to sleep enough each night to feel well rested in the morning, should that be their wakeup call that they are taking on too much, or that they need to adopt better time management strategies?
A: If they feel sleepy during the day, are falling asleep in class, and are not energetic, it is time to look at getting more sleep and modifying daily routines.
Maria: I've used both natural and conventional over-the-counter and prescription-based sleep aides in the past. While most claim to not be habit-forming, I found that they are all too easy to become psychologically dependent on. I felt like I couldn't sleep without them, but sometimes people need them to get over the initial hump. What is your take on both herbal and conventional sleep aides?
A: There is little evidence that over the counters, including herbal products, work for insomnia. Prescription sleep aids are fine for short-term intermittent use but not on a regular basis for chronic insomnia due to side effects and loss of effectiveness with regular use.
Maria: I've found both Yoga and meditation to be very beneficial in calming my body and mind down when I'm stressed, which helps me sleep better. Would you recommend these methods for stressed-out students and what else would you recommend for overall relaxation?
A: Simple relaxation techniques, which are available on my website in MP# and compact disk format, involving 20 minutes of muscle relaxation, breathing, and visual imagery techniques will improve sleep in many people. There is little research on yoga but mediation helps many people.
Maria: Some students stress about homework, replay arguments with friends etc right before bed. Can you talk for a moment about negative self-talk and how that contributes to poor sleep?
A: Negative self-talk about sleep creates insomnia. Negative self-talk about stressors from the day will do the same.
Maria: What does a positive sleep environment look like?
A: Cool, dark, and quiet.
Maria: Anything else you'd like to add?
A: Insomnia can be treated effectively with CBT in 80 percent of patients- and it helps people reduce or eliminate sleep meds. It can be accessed easily, effectively, and inexpensively at www.cbtforinsomnia.com.
(c) 2008 Maria L. Pascucci / Campus Calm.
About the author:
Maria Pascucci is the President of Campus Calm - the award-winning online-community for today's stressed-out students, and their parents and educators. Download your Student Life Stress-Out Less Kit with 4 FREE gifts at www.campuscalm.com. A summa cum laude college graduate, Maria is also the President of the International Campus Calm University Student Association at CampusCalmU.com.
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