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Index

A

Cognitive behavioral model of insomnia and

Alcohol

anxiety, 7–9

effects on sleep, 17, 18, 20, 26–28, 40, 43,

Cognitive behavioral treatment of nocturnal

69–70, 83, 90–91, 94, 96, 117, 118, 121

panic, 131–134

recommendations in treatment, 52, 84–89,

Cognitive behavior therapy for insomnia

91, 94

combination with sleep medications,

Anxiety disorders

63–66, 71–73

generalized anxiety disorder (GAD), 3,

evidence for effectiveness, 55–58

26–27, 35–37, 96, 124

evidence for efficacy, 55, 56, 58

obsessive compulsive disorder, 40–42

multicomponent CBT, 57, 125

panic disorder (PD), 22–23, 25–26, 33–35,

psycho education, 84–86, 112

42, 45, 124, 131, 135

relapse prevention, 119

post-traumatic stress disorder (PTSD), 26,

sleep hygiene, 52, 53

37–40, 138

sleep restriction, 52, 53

social phobia, 24–25, 34, 42–43

stimulus control, 52, 53, 57

specific phobia, 43–45

treatment adherence, 84

Assessment of sleep

treatment delivery issues, 56–58

actigraphy, 15

trouble-shooting, 94–96

clinical interviews, 18

Cognitive factors

polysomnogram, 13

attention, 54, 99–100, 103–104, 106

self-report questionnaires, 18–21

(
See also
Attentional bias)

sleep diary, 15–17

attributions, 104–105

structured interviews, 22–26

helplessness, 100, 102, 112

Attentional bias, 54, 103–106

mental overactivity, 101 (
See also

Cognitive arousal)

sleep effort, 103, 112

B

sleep-related threats, 104

Behavioral experiments, 112, 117–120

Cognitive model of insomnia, 7–9

Benzodiazepines

Cognitive restructuring

effects on sleep, 65, 70

hot thought, 115, 116

Body clock, 84–87

thought record, 113–117

Combining sleep medications with CBT for

insomnia, 71–73

C

Comorbid insomnia, 4–9, 105

Caffeine, 17, 18, 26, 27, 52, 89, 90, 92, 94,

100, 112, 121, 132

Circadian rhythm sleep disorder, 3, 83, 84

D

Circadian system, 68, 112.
See also
Body clock

Daytime insomnia symptoms, 20–21

Cognitive arousal, 56, 109

Deep stages of sleep, 35–36

149

150

Index

Depression, 2, 5–6, 21, 25, 27, 28, 34, 38, 40,

Relaxation-induced anxiety, 34

42, 43, 67, 70, 93, 106, 115, 138.
See

Relaxation therapies, 52, 55, 75, 102,

also
Major depressive disorder

123–125, 127, 131

Dream/nightmare re-scripting, 24, 38, 40, 69,

Residual insomnia, 6–8, 22, 33, 36, 39, 45

138–143

S

E

Safety behaviours, 8, 20, 40, 100, 106,

Exercise, 52, 74, 86, 91, 92, 111, 112, 115,

117–120

117, 119, 123, 126–130, 132–135, 141

Selective serotonin and norepinephrine

reuptake inhibitors

effects on sleep, 70

F

Selective serotonin reuptake inhibitors

Fear of sleep, 44, 45

effects on sleep, 70

Fear of the dark, 44

Sleep continuity, 36, 38, 41, 117

Sleep disordered breathing

obstructive sleep apnea, 21, 134, 136,

I

137, 144

Insomnia

Sleep efficiency, 19, 26, 34, 35, 43, 75,

definition, 1

119, 120

diagnosis, 2–4, 6

Sleep-interfering substances, 18

prevalence, 1, 2

Sleep medication discontinuation strategies,

73–75

Sleep need, 83–86, 88, 112

L

Sleep onset latency/time to fall asleep, 3, 4,

Light stages of sleep, 35

14–17, 19, 21, 26, 35, 36, 43, 65, 68,

80–83, 85, 93, 101, 104, 112, 117, 124

Sleep state misperception, 38

M

Major depressive disorder, 3, 119

Medications

T

herbal sleep remedies and alternative

Time-in-bed calculations.
See
Time-in-bed

treatments, 66–70

prescriptions

hypnotic medication dependence, 63–65,

Time-in-bed prescriptions, 52, 86–89,

71–74, 124

91–93, 96

over-the-counter sleep medications, 66–70

Time spent in bed (TIB), 17, 34, 35, 52, 83,

problems with sleep medication, 27

86–89, 91–93, 96

types of sleep medication, 17, 41, 70

Total time asleep (TST), 3, 4, 15–17, 19, 21,

Melatonin, 65, 68–69

26, 34, 52, 65, 69, 80–83, 85, 88, 93,

Movement time on PSG, 34

104, 112, 117, 124

Treating claustrophobia associated with CPAP,

134–138

N

Napping, 16, 17, 26, 40, 52, 54, 55, 73, 80–83,

86, 88, 90, 94, 95, 139

U

Nightmares, 24, 27, 28, 33, 38–40, 45, 69,

Unhelpful beliefs about sleep, 19, 28, 42, 53,

123, 138–144

54, 71, 73, 84, 102, 106, 140

R

W

Rapid eye movement sleep, 38, 69

Wakefulness after sleep onset (WASO), 36

Relaxation, 27, 34, 51, 52, 55, 69, 75, 87, 91,

Worry

92, 94, 102, 105, 110, 113, 114, 116,

worry management strategies in insomnia,

120, 123–131, 134, 140, 141

109–110

• 1441914331
  
• Series in Anxiety and Related Disorders
  
• Insomnia and Anxiety
  Series in Anxiety and Related Disorders
  
  • Acknowledgements
    
• Acknowledgements
  
• Contents
  
• Chapter 1
  
  • Anxiety and Insomnia: An Overview
    
    • What is Insomnia?
      
    • Diagnostic Considerations for Insomnias
      
    • The Case of Comorbid Insomnia: More Nosological Issues
      
      • Cognitive Behavioral Model of Insomnia and Anxiety
        
    • Summary
      
  • References
    
• Chapter 2
  
  • Considerations for Assessment
    
    • Assessment of Sleep
      
    • Actigraphic Measurement of Sleep
      
    • Subjective Assessment of Sleep
      
    • Clinical Interview
      
    • Self-report Measurement
      
      • Global Sleep Symptom Questionnaires
        
      • Cognitive Insomnia Questionnaires
        
      • Behavioral Insomnia Questionnaires
        
      • Daytime Insomnia Symptom Questionnaires
        
    • Assessment of Anxiety
      
    • Structured Interviews for Anxiety
      
      • Clinician-Administered Interviews for Anxiety
        
      • Clinician-Administered Interviews for Specific Anxiety Disorders
        
      • Self-Report Measures for Anxiety Symptoms
        
      • General Measures for Self-Reported Anxiety
        
      • Anxiety Disorder-Specific Self-Report Questionnaires
        
    • Case Example 1: Generalized Anxiety Disorder and Insomnia
      
    • Case Example 2: Sleep-Specific Worry
      
  • References
    
• Chapter 3
  
  • Anxiety Disorders and Accompanying Insomnia
    
    • Panic Disorder
      
    • Generalized Anxiety Disorder
      
    • Posttraumatic Stress Disorder: PTSD
      
    • Obsessive–Compulsive Disorder
      
    • Social Phobia
      
    • Specific Phobias
      
    • Summary
      
  • References
    
• Chapter 4
  
  • Cognitive Behavior Therapy for Insomnia: Treatment Considerations
    
    • What is Cognitive Behavior Therapy and Who Can Benefit from It?
      
    • Cognitive Behavior Therapy Model
      
    • The Evidence Supporting CBT for Insomnia
      
    • Treatment Delivery Issues
      
  • References
    
• Chapter 5
  
  • Medication Considerations
    
    • Will Cognitive Behavior Insomnia Therapy Work with Those Who Use Sleep Medications?
      
    • Prescription Hypnotics: Advantages and Disadvantages
      
    • Over-the-Counter Medications, Herbal Remedies, and Alternative Treatments
      
      • Antihistamine-Based Sleep Aids
        
      • Herbal Compounds and Dietary Supplements
        
      • Melatonin
        
      • Alcohol
        
    • Can Common Anxiety Medications Cause Insomnia Symptoms?
      
    • Combining Sleep Medications with CBT for Insomnia
      
    • Sleep Medication Discontinuation Strategies
      
  • References
    
• Chapter 6
  
  • Behavioral Strategies for Managing Insomnia
    
    • Assessing the Sleep Problem Using the Sleep Diary
      
    • Setting the Stage for Treatment Recommendations: The Role of Psychoeducation
      
    • Presenting Behavioral Insomnia Treatment Recommendations
      
    • Addressing Sleep Hygiene Issues
      
    • The Value of Follow-Up Sessions
      
    • Assistance with TIB Changes
      
    • Reviewing/Reinforcing Adherence
      
    • Trouble-Shooting Problems
      
      • Case 1
        
      • Case 2
        
      • Case 3
        
  • References
    
• Chapter 7
  
  • Sleep-Related Cognitive Processes
    
    • Harvey’s (2002) Cognitive Model
      
    • The Role of Thoughts
      
      • Unwanted Repetitive Mental Activity
        
    • The Role of Distress
      
    • Beliefs in Insomnia
      
    • Attention and the “Threat” of Sleep
      
    • The Role of Attributions
      
    • Maintaining the Status Quo
      
  • References
    
• Chapter 8
  
  • Cognitive Strategies for Managing Anxiety and Insomnia
    
    • Worry Management Strategies
      
    • Constructive Worry Worksheet Example
      
    • Cognitive Restructuring
      
    • Thought Record
      
    • Decreasing Safety Behaviors and Behavioral Experiments
      
    • Focus on Relapse Prevention
      
    • Action Plan for Addressing Insomnia
      
    • Red Flags for a Possible Problem with Insomnia
      
    • What Tools Work for This Problem?
      
  • References
    
• Chapter 9
  
  • Other Issues in Managing the Sleep of Those with Anxiety
    
    • Relaxation-Based Strategies
      
    • PMR Treatment Outline
      
    • Cognitive Behavioral Treatment of Nocturnal Panic
      
    • Craske’s Nocturnal Panic Protocol
      
    • Treating Claustrophobia Associated with Sleep Apnea Treatment
      
    • Dream/Nightmare Rescripting
      
    • Is it Time for a Sleep Specialist Consultation?
      
  • References
    
• Index