Cognitive behavioral therapy, a type of “talk” therapy, may help ease the severity of insomnia, fatigue, and anxiety in people with multiple sclerosis (MS), improving the quality of their sleep, data from a single-site trial suggest.
The study “Feasibility and Treatment Effect of Cognitive Behavioral Therapy for Insomnia in Individuals with Multiple Sclerosis: A Pilot Randomized Controlled Trial” was published in the journal Multiple Sclerosis and Related Disorders.
Estimates point to almost 70% of MS patients having difficulties sleeping, and at least 40% report chronic insomnia. Poor sleep also worsens the daily fatigue that affects quality of life.
These difficulties are thought to arise either from the damage to myelin (the protective layer of nerve cell axons) and to brain regions that control sleep, or from physical pain, spasticity (muscular stiffness and contractions), medication effects, bladder problems, or psychological factors including depression and anxiety.
Insomnia is characterized by trouble falling asleep, difficulty maintaining sleep, or waking up too early for at least three nights each week for three consecutive months.
Cognitive Behavioral Therapy for Insomnia (CBT-I), a type of psychotherapy or “talk” therapy for insomnia, focuses on changing behaviors or thoughts that influence sleep. This type of therapy is currently the most recommended non-pharmacological treatment for insomnia.
CBT-I techniques include stimulus control, restrictions on time spent in bed, education on sleep hygiene and cognitive strategies, and relaxation techniques to help patients to improve their sleep quality.
Previous studies have demonstrated that long-term use of CBT-I is more effective in improving sleep than medications. Yet few studies have addressed CBT-I with MS patients reporting sleep difficulties, and the numbers of participants in those that have were very small, so that “the interpretation of these results is difficult,” the researchers wrote.
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