Insomnia: A Clinical Guide to Assessment and Treatment

ISBN-13: 9780306477508 / Angielski / Twarda / 2003 / 190 str.

Charles M. Morin; Colin A. Espie

Opis

Along with increasing recognition of the consequences and costs of ins- nia, there is growing evidence documenting the effectiveness of cogniti- behavior therapy for insomnia. Yet, there is still a major gap between available evidence and current clinical practice. Much of this gap is due to economics, limited treatment access, and ineffective dissemination of knowledge. There is a definite need for practical materials to facilitate access to and implementation of interventions for insomnia. As scientis- practitioners, we are constantly reminded of this need by frequent requests from clinicians around the world for questionnaires and handouts to assist them in treating insomnia patients. It was during a recent international sleep meeting, more specifically on a trainjourney between Dresden and Prague, that we drafted an outline of a handbook that would help fill this gap. This clinical handbook describes an evidence-based treatment p- gram for insomnia. Its content is based on materials that have been cl- ically tested and validated with patients in various settings and with different subtypes of insomnia. The manual is divided into eight chapters. Chapter 1 presents an introduction to sleep and provides answers to f- quently asked questions about the nature of sleep, its determinants, and about the consequences of sleep loss and insomnia. Chapters 2 and 3 outline the main clinical features of insomnia and differential diagnostic issues and describe a practical approach to the assessment of insomnia complaint.

Spis treści

1: The basics of sleep. Introduction. The nature and organization of sleep. Biopsychosocial determinants of sleep. Sleep needs. The consequences of sleep deprivation. 2: Clinical features of insomnia. Introduction. Clinical presentation. Definition. Concomitant laboratory findings and clinical features. Course and prognosis. Insomnia as a symptom or a syndrome. Does your patient suffer from insomnia? 3: Assessment and differential diagnosis of insomnia. Introduction. The assessment of insomnia. Differential diagnosis of insomnia. Clinical formulation of the sleep problem. 4: Sleep hygiene and relaxation therapy. Introduction. Rationale for sleep hygiene. Practical instructions for using sleep hygiene advice. Rationale for relaxation therapy. Practical instructions for using relaxation therapy. Implementation issues with relaxation therapy. Clinical vignette. 5: Sleep scheduling. Introduction. Rationale for sleep scheduling. Practical instructions for using sleep scheduling. Implementation issues. 6: Cognitive therapy. Introduction. The role of dysfunctional cognitions in insomnia. Rationale and objectives. Principles and practice of cognitive therapy. Practical recommendations for changing beliefs and attitudes about sleeplessness. Clinical vignettes. Treatment implementation issues. Supporting evidence. Other cognitive approaches. 7: Sleep medications. Introduction. Types of medications used for insomnia. Clinical benefits, risks, and limitations. Indications and contra-indications. Clinical guidelines on the appropriate use of sleep medication. Combining psychological and pharmacological approaches. Clinical guidelines for hypnotic discontinuation. Conclusions. 8: Clinical and treatment implementation issues. Introduction. Treatment implementation formats - individual, group, and brief consultations models. Treatment parameters - frequency, timing and duration of treatment. Strategies to promote compliance. Treatment of special populations. References.

O autorze

Dr. Charles M. Morin joined the School of Psychology at Université Laval in 1994, after postdoctoral training at the Medical College of Virginia, where he then worked as professor and director of the Sleep Disorders Center (from 1987 to 1994). Dr. Morin directs research on insomnia (subsidies of the National Institute of Mental Health and the IRSC) and co-directs work on the relation between sleep and cognitive and immunological functions (subsidy of the IRSC), and on empirically validated psychotherapies (subsidy of the FCAR). He is also a member of the Office of Direction of the Mental Health Network (Axis Sleep – subsidy of the FRSQ). He is an assistant head of the review for Behavioral Sleep Medicine and part of the editorial board of several scientific reviews. He directs the Center on Sleep Disorders and is a member of the Research Center Université Laval Robert-Giffard (CRULRG). He was a director of the doctorate program (Ph.D., clinical orientation), from 1995 to 2000. In 1995, the American Psychological Association (APA) awarded him the Distinguished Early Career Award for his exceptional contribution to health psychology.