UF psychologist helps patients put an end to restless nights

August 8, 2006

GAINESVILLE, Fla. – For 40 million Americans, a good night’s sleep is little more than an impossible dream. But there are a number of effective therapies for insomnia, and frequently the best treatments do not come in a pill, says Christina McCrae, a University of Florida assistant professor.

McCrae has recently launched a behavioral sleep medicine clinic in the UF College of Public Health and Health Professions’ department of clinical and health psychology. As a board-certified specialist, McCrae uses psychological interventions to help people change their thinking about sleep and put an end to counterproductive bedtime habits.

In a number of patients, insomnia can be caused by a psychological condition such as anxiety or depression. Insomnia can also be a side effect of some medications and can be attributed to chronic medical conditions such as pain, cardiovascular disease and cancer, which is especially true in seniors.

“Six months or more of insomnia is termed chronic and some people have had sleep problems for years,” said McCrae, adding that the average bout of chronic insomnia lasts seven years.

The most common prescribed treatment for insomnia is sleep medications, but they can present their own set of problems, McCrae said.

“Over the long term, people develop a tolerance to the medication and their sleep problems go back to baseline,” she said. “And when patients go off the medication they can suffer from withdrawal symptoms.”

One of the first steps in behavioral therapy is helping patients associate the bed with its intended purpose – sleep.

“Insomniacs do things in the bedroom that have nothing to do with sleep,” McCrae said. “So the bedroom becomes associated with arousing activities such as reading or watching television. We need to eliminate these kinds of bedroom activities so that the patient can re-establish the connection between bedroom and sleep.”

Another behavioral therapy technique requires patients to get out of bed when the tossing and turning starts.

“Insomniacs spend a lot of time in bed, but for much of that time they are not sleeping,” McCrae said. “They may spend 10 hours in bed, but only get five hours of sleep. If you can’t sleep, don’t lie in bed – get up and only come back to bed when you feel sleepy.”

It may relieve people with sleep problems to know that the gold standard of eight hours of sleep a night is a myth and over the life span, the amount of sleep a person needs decreases.

“The amount of sleep you need varies from person to person,” McCrae said. “The key is, how do you feel the next day? If you feel well rested and have no difficulties functioning, then you have found the right amount of sleep for you.”