CBT for insomnia may work but better access is required

A new study has shown that cognitive behaviour therapy may improve insomnia – but the RCGP has highlighted the issue of access

The Royal College of GPs (RCGP) has responded to new research showing that cognitive behaviour therapy for insomnia (CBT-1) can be effective in primary care.

The British Journal of General Practice conducted 13 studies and found CBT-I had a positive effect after 4-6 sessions.

The RCGP has said that, while this is good news, it raises questions about access to CBT.

Professor Helen Stokes-Lampard, chair of the RCGP, said: “Insomnia can cause huge distress and frustration for patients, and can have significant long-term health implications.

“For many patients, sleeping tablets can seem like an obvious treatment option, but they are not usually effective for more than a few days, and GPs will only use them as a last resort after alternatives have been explored due to the risks of addiction and tolerance.

“Cognitive Behavioural Therapy (CBT) tailored to insomnia has been a first-line treatment option for some time, and we know many patients have found it beneficial, so it is really positive that its effectiveness has been shown by this research today.

“Unfortunately, access to treatments such as CBT in the NHS can be extremely difficult to come by in the community and are very variable across the country.

“This needs to be addressed, firstly by realising the pledge made in NHS England’s GP Forward View for every GP practice in the country to have access to one of 3,000 new mental health therapists by 2020/21 and by the provision of many additional psychologists trained to deliver CBT.

“Other measures patients with insomnia can take to improve their condition include practising good ‘sleep hygiene’ before they go to bed, for example limiting the amount of alcohol and caffeine they drink, as well as identifying lifestyle factors that might be causing stress or anxiety.

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“Achieving parity of esteem between physical and mental health is an enduring priority for the College and we have developed resources to support GPs and other healthcare professionals to deliver the best possible care to our patients with mental health conditions, including insomnia.”

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