Insomnia: Evidence-Based Strategies for Depression, Trauma, Anxiety and Chronic Pain

CPD

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Speaker

Colleen Carney, PhD Related seminars and products

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Colleen E. Carney, PhD, is on faculty in the department of psychology at Toronto Metropolitan University, where they are the director of the sleep and depression laboratory. They are a leading expert in psychological treatments for insomnia, particularly in the context of co-occurring mental health issues. Their work has been featured in The New York Times and they have over 100 publications on insomnia.

Dr. Carney frequently trains students and mental health providers in CBT for Insomnia at invited workshops throughout North America and at international conferneces. Dr. Carney is a passionate advocate for improving the availability of treatment for those with insomnia and other health problems. For more information, please visit www.drcolleen carney.com

Speaker Disclosures:
Financial: Dr. Colleen Carney has employment relationships with Toronto Metropolitan University and Duke University. They receive a grant from Canadian Institutes of Health Research, Team Research, and Sleep Research Consortium and received Faculty of Arts Travel Award. Dr. Carney receives royalties as a published author. They receive a speaking honorarium and recording royalties from PESI, Inc. Dr. Carney has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Colleen Carney is a member of the Canadian Association of Cognitive and Behavioural Therapies, the Canadian Psychological Association, the Association for Behavioural and Cognitive Therapies (ABCT), the Canadian Sleep and Circadian Network, the Canadian Sleep Society, the Sleep Research Society, and the Canadian Association for Cognitive Behaviour Therapy.

Alternate Options

Objectives

• Identify sleep disorders which require referrals to a sleep center.
• Integrate strategies for pre-sleep arousal by building a stronger drive for deep sleep.
• Discuss why CBT-I is effective for clients with co-occurring issues such as pain, depression, anxiety or trauma.
• List treatment strategies clients can easily implement to manage their fatigue.
• Design behavioral experiments for clients to test unhelpful beliefs about sleep.
• Identify conditioned arousal and teach clients strategies to reverse it.

Outline

Sleep Regulation

• Sleep homeostasis
• Behaviors that interfere with the build-up of sleep-drive
• The circadian system
• Behaviors that interfere with optimal timing of sleep
• Arousal system: behaviors that cause conditioned arousal and cognitive emotional hyperarousal

Assessment

• How to get useful information from sleep diaries
• The difference between sleepiness and fatigue
• When to make a referral to a sleep clinic
• Other assessment issues

Cognitive Behavior Therapy for Insomnia (CBT-I)

Sleep Restriction Therapy (SRT): Restore the Sleep Drive

• Calculate optimal time-in-bed prescription
• Collaborate on the best “sleep window”
• Special cases: when to use sleep compression instead

Stimulus Control (SC): Addressing Conditioned Arousal

• Select an optimal standard rise time
• Fatigue management strategies to eliminate napping
• Special cases: when to use counter control instead
• Combining SC and SRT in one-session CBT-I

Counter-arousal Strategies

• Identify and change negative thoughts that keep people awake
• Behavioral experiments
• Thought records
• The buffer zone
• Socratic questioning
• Structured, scheduled problem-solving
• Mindfulness
• Troubleshooting difficulties with adherence
• High sleep anxiety vs. high arousal
• Awakenings from pain, hot flashes, panic or nightmares
• Using light and activation in those with depression

Modifications to CBT for Insomnia in Complex Cases & Comorbidity

• Major Depressive Disorder
• Chronic pain
• Anxiety disorders
• Post-Traumatic Stress Disorder

Implementation Issues

• Relapse prevention
• Delivery issues

Target Audience

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