We’re not sleeping enough
Sleeplessness is epidemic in this country.
The Centers for Disease Control (CDC) consider insomnia a public health issue and report that at least 35% of adults don’t get a good night’s sleep.
Judging from my circle of friends, I think the percentage is much higher than that!
Insomnia and daytime fatigue make life miserable and contribute to chronic illness. Drowsy drivers cause accidents. Drowsy employees cause on-the-job injuries.
Sleeping pills (hypnotics) are the go-to treatment in the US. Drugs like zolpidem (Ambien), eszopiclone (Lunesta) and suvorexant (Belsomra).
Related post: First sleep, second sleep
But they have side effects and are usually not recommended for long-term use.
Help getting a better night’s sleep
Two professional groups, the American Academy of Sleep Medicine and the American college of Physicians, suggest using Cognitive Behavioral Therapy (CBT) to treat chronic sleeplessness rather than sleeping pills.
[A] recent systematic review of insomnia treatments—drug treatments, behavioral therapy, and alternative therapies—by the federal Agency for Healthcare Research and Quality (AHRQ)—found strong scientific evidence that shows cognitive behavioral therapy (CBT) for insomnia is a consistently effective way to treat the problem.
It works like this: a provider is trained to help teach you better sleep habits, develop regular sleep cycles, and suggest ways to change your behavior, using techniques such as sleep restriction and controlling stimulus, while also working to change the way you think about sleep.
The report found CBT to be effective for most adults with chronic insomnia, and safer because there are few, if any, side effects. CBT might also potentially keep insomnia at bay longer than medication—even after the therapy ends.
Other studies have shown that CBT is as effective provided over the telephone or online, as with a face-to-face counselor.
That’s good news, because weekly therapy sessions can be costly, not to mention the inconvenience of taking time off work, fighting traffic and finding a parking place (at least in Seattle, where both traffic and parking are awful!)
Enter Sleepio and SHUTi
Which brings me to two websites that offer personalized CBT sessions along with a variety of tools and patient education materials: Sleepio and SHUTi (shut eye, get it?)
They differ a little in respect to how they deliver their services as well as what they charge. But they both teach CBT skills with the aim to
- change poor sleep habits
- promote better sleep hygiene
- change negative thoughts and attitudes about sleep
Sleepio is a UK-based website. Studies have shown it to be effective in improving sleep. It costs $300 for 12-month access that includes a personalized sleep plan, weekly progress chats with a sleep professional, a sleep diary, webinars and other tools. It can be used with iPads and iPhones, as well.
Overall, I think SHUTi is a better deal, as anyone desperate enough to seek help for insomnia will be motivated to complete the program as quickly as possible.
CBT cannot solve all sleep problems. It’s mostly used for what is called primary insomnia, or insomnia not caused by another underlying health problem, such as chronic pain, sleep apnea, or restless leg syndrome.
Both Sleepio and SHUTi start with a patient questionnaire, however, so you know if the program will be right for you.
I should note that I am not in any way associated with either of these products. I just think they are an innovative and cost effective way to provide sleep therapies to a larger number of people.
I would love to see more insurance companies or large employer groups embrace programs like these and provide them at a lower rate. Insomnia is a huge problem in this country, and it costs us all, one way or another.