Sleep is a foundational health behaviour, and its disturbance is a feature of many psychological and medical disorders. It was previously thought that treating the primary disorder would resolve the secondary sleep disturbance. We now know that unmanaged insomnia is a significant predictor of the development of several mood and anxiety disorders, increases relapse rates after treatment, and has short- and long-term health consequences. Fortunately, psychologists are well equipped to assess and address insomnia and other sleep disorders. Cognitive-behavior therapy for insomnia (CBT-I) is a highly effective non-pharmacological intervention recommended as a first line treatment (APA, AASM, ACP). This multicomponent intervention integrates circadian science, behavioral principles of conditioned learning, and cognitive therapy to address the factors that maintain sleep difficulty. Strong evidence demonstrates that the treatment gains from CBT-I are significantly better maintained over time relative to hypnotic medication therapies. This presentation will briefly review etiology and pathophysiology, and provide practical direction for assessment and treatment of insomnia, with special consideration of clinical tips for interventions when insomnia is comorbid with other physical and psychological disorders.
Dr. Sheila Garland is a full professor in the departments of Psychology and Oncology at Memorial University in St. John's, Newfoundland and Labrador and a registered clinical psychologist. She completed her PhD at the University of Calgary, the Calgary Clinical Psychology Residency program, and completed a 3-year post-doctoral fellowship in behavioral sleep medicine and psycho-oncology at the University of Pennsylvania. Her research is focused on understanding the experience and testing interventions to improve insomnia and other symptoms in people diagnosed with cancer with a special emphasis on adolescents and young adults. She has published 135 peer reviewed research papers, nine book chapters, and regularly presents her research at national and international research meetings. She is a graduate fellow in randomized behavioral clinical trials from the National Institutes of Health in the USA and has led the design and conduct of five highly successful clinical trials of behavioural interventions for insomnia. Dr. Garland is currently Chair of the Health Psychology and Behavioral Medicine section of the CPA. She holds a 5-year Canadian Cancer Society Emerging Scholar Award to develop a mobile application for delivery of cognitive behavioral therapy for insomnia in cancer populations.
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