TEACHING THE WORLD TO SLEEP : psychological and behavioural assessment and treatment strategies... for people with sleeping problems and insomnia

Teaching the World to Sleep provides a complete, science-based overview of sleep and sleep problems, from environmental, legal, and technological factors to assessment and treatment options. David R. Lee introduces the basic scientific concepts involved in sleep and provides a clear description of insomnias and the parasomnias. Teaching the World to Sleep discusses NICE-recommended Cognitive Behavioural Therapy for Insomnia (CBT-i) and the REST programme® and outlines considerations for at-risk groups, sleep and the law, and the application of dreams and dreaming in psychotherapy. This second edition includes a full update on research conducted since the publication of the first edition and includes new information on sleep in the legal setting, the rise of sleep apps and trackers and their impact on our sleep. Lee also considers neurodiversity, sleep in long Covid, rare and unusual sleep disorders and the delivery of treatment using the NHS-recommended stepped-care approach. Teaching the World to Sleep will be essential reading for psychotherapists, occupational therapists, and other professionals working with clients with sleep problems. It will also provide an accessible introduction to the science of sleep to readers looking to understand their own sleep problems. List of illustrations Acknowledgements Introduction 1 The science of sleep States of consciousness Circadian and ultradian rhythms Sleep stages Memory and schemas Age-related changes Chronotypes The influence of light The sleep homeostat and the napping debate “Time givers” Physiological impacts Psychological impacts Pulling it all together 2 Insomnias and the parasomnias A definition of insomnia Types of insomnia and parasomnia Difficulty initiating sleep (DIS) Difficulty maintaining sleep (DMS) Early morning awakening (EMA) Transient insomnia Acute insomnia Chronic insomnia Psycho-physiological (primary) insomnia Comorbid insomnia Adjustment insomnia Circadian / schedule insomnia Advanced sleep phase syndrome Shift work Jet lag Hypersomnia Parasomnias Those parasomnias common in children Nightmares Sleepwalking (somnambulism) Sleep talking (somniloquy) Enuresis Restless Sleep Syndrome Those parasomnias occurring at any age Night terrors Bruxism Sleep paralysis REM sleep behaviour disorder Periodic leg movements Restless legs syndrome The more unusual parasomnias Sexsomnia Sleep homicide Sleep-related eating disorder Exploding head syndrome Jactatio capitis nocturna Agrypnia Excitata Sleep apnoea Obstructive sleep apnoea Central sleep apnoea Catathrenia Narcolepsy Sleep-state misperception The natural history of insomnia Case example one Case example two Cognitive models of insomnia A state of hyperarousal Orthosomnia 3 The assessment of sleep Electrodes and sleep laboratories Actigraphy Paper-based assessments Sleep applications Sleep trackers Heart Rate Variability 4 The treatment of sleep problems and insomnia Drug treatments Benzodiazepines Toxicity Tolerance Dependency Rebound insomnia Withdrawal Hangover effects The “Z” drugs Efficacy Half-lives Once you start, you cannot stop Psychobehavioural treatments Psychoeducation Sleep hygiene Relaxation training Stimulus control theory and therapy Sleep restriction therapy Paradoxical intention Bright light therapy Imagery rehearsal Efficacy of the psychobehavioural treatment approaches The limits of our knowledge and application Cognitive behavioural therapy for insomnia (CBT-i) Elements and process Group and digital CBT-i Efficacy of psychobehavioural insomnia treatment approaches 5 The REST Programme® The assessment tool Elements of the REST treatment programme® The first element is Routine The second element is Environment The third element is Stimulation control The fourth element is Thinking Routine Environment Get a comfortable bed Get some thick curtains Look for ways to reduce noise in the bedroom or surrounding rooms/outside Try to reduce “clutter” in your bedroom Bedding Stimulation control Drinking too much in the evening Drinking caffeine and alcohol Smoking Exercise Eating close to bedtime Importing sleep inhibiting items into the bedroom Bathing too close to bedtime Screen use and the blue light debate Thinking Treatment procedures Presentation one Interventions from REST®: Presentation two Interventions from REST®: Presentation three Interventions from REST®: Beyond REST® Sleep restriction therapy (SRT) Paradoxical intention The shown discrepancy method Bright light therapy Vitamin D, magnesium, and other supplements Interesting developments in the world of repetitive transcranial magnetic stimulation (rTMS) Delivery using a stepped-care approach Summary 6 Considerations for at-risk groups Older people Younger people Co-sleeping, continual attention, immediate intervention Extinction approaches Gradual extinction Sleep and age considerations Teenagers People living with chronic pain Chronic fatigue syndrome (CFS), fibromyalgia, and myalgic encephalomyelitis (ME) Long Covid and Post Viral Syndrome Multiple sclerosis Alcohol dependency syndrome Eating disorders Head injury Neurodiversity and Autism spectrum disorder (ASD) People with dementia Alzheimer’s disease Vascular dementia Lewy body dementias Sleep management in dementia Carers Pregnancy The menopause Sleep in recreational drug users Contraindications for REST programme® interventions Summary 7 Dreams and dreaming Background and beginnings in psychotherapy Expectation fulfilment The continuity hypothesis The activation–synthesis hypothesis Threat simulation theory Cognitive theory of dreaming The clinical utility of dreams in therapy A summary of the theoretical literature on dreaming and the therapeutic utility of dreamwork 8 Sleep and the law Introduction Civil Proceedings Personal Injury Case management Multidisciplinary working Criminal proceedings Forensic sleep medicine Sexsomnia Sleep-related violence Criteria for defence Features that support or refute a parasomnia defence The capacity of the expert witness and the expectations of the court Conclusions Epilogue References Index