Carney / Edinger Insomnia and Anxiety

1. Auflage 2010
ISBN: 978-1-4419-1434-7
Verlag: Springer
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 155 Seiten

Reihe: Series in Anxiety and Related Disorders

The statistics show that as much as twenty percent of the population suffers from chronic insomnia-and one-fourth of those with the condition eventually develop an anxiety disorder. As comorbid conditions, they contribute to any number of physical and social problems. Yet too often insomnia is undiagnosed, or treated as merely a symptom of the patient's anxiety. Insomnia and Anxiety is the first clinician guidebook that considers the evaluation and management of insomnia and related sleep disturbances that occur conjointly with the common anxiety disorders. By exploring the ways that one condition may exacerbate the other, its authors present robust evidence of the limitations of viewing insomnia as secondary to GAD, agoraphobia, PTSD, and others in the anxiety spectrum. The book reviews cognitive and emotional factors common to anxiety and sleep disorders, and models a cognitive-behavioral approach to therapy in which improved sleep is a foundation for improved symptom management. Beginning and veteran practitioners alike will find vital insights into all areas of these challenging cases, including: Diagnostic and assessment guidelines. Cognitive-behavior therapy for insomnia. Behavioral strategies for managing insomnia in the context of anxiety. Cognitive strategies for managing comorbid anxiety and insomnia. Sleep-related cognitive processes. Pharmacological treatment considerations. Insomnia and Anxiety is highly useful to clinical psychologists given the range of treatment strategies it describes and to researchers because of its emphasis on the theoretical and empirical bases for its interventions. In addition, its accessible style makes it an excellent training tool for students of therapy and psychopathology.

Colleen E. Carney, Ph.D. is an Assistant Professor in the Ryerson Sleep and Depression Laboratory. She received her doctorate in Clinical Psychology at Louisiana State University, and completed two postdoctoral training fellowships: one in Cognitive Therapy for Depression and the other in Cognitive Behavior Therapy for Insomnia. She is currently the President of the Insomnia Special Interest Group of the Association for Behavioral and Cognitive Therapies. Dr. Carney's research and clinical focus is on the treatment of the comorbid insomnia that occurs in emotional disorders such as depression and anxiety. She has an active clinical practice at the Duke Insomnia and Sleep Research Program at Duke University Medical Center. Jack D. Edinger, Ph.D. is a Clinical Professor in the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center, and Senior Psychologist at the Durham Veteran's Affairs Medical Center. He is certified in Behavioral Sleep Medicine by the American Academy of Sleep Medicine with 25 years of clinical and research experience with sleep-disordered patients. Dr. Edinger practices at the Duke Insomnia and Sleep Research Program at Duke University Medical Center.

Autoren/Hrsg.

Carney, Colleen E.

Edinger, Jack D.

Inhaltsverzeichnis

1;Insomnia and Anxiety Series in Anxiety and Related Disorders;2
1.1;Acknowledgements;7
2;Chapter 1;11
2.1;Anxiety and Insomnia: An Overview;11
2.1.1;What is Insomnia?;12
2.1.2;Diagnostic Considerations for Insomnias;13
2.1.3;The Case of Comorbid Insomnia: More Nosological Issues;14
2.1.3.1;Cognitive Behavioral Model of Insomnia and Anxiety;17
2.1.4;Summary;19
2.2;References;19
3;Chapter 2;22
3.1;Considerations for Assessment;22
3.1.1;Assessment of Sleep;22
3.1.2;Actigraphic Measurement of Sleep;24
3.1.3;Subjective Assessment of Sleep;24
3.1.4;Clinical Interview;27
3.1.5;Self-report Measurement;27
3.1.5.1;Global Sleep Symptom Questionnaires;27
3.1.5.2;Cognitive Insomnia Questionnaires;28
3.1.5.3;Behavioral Insomnia Questionnaires;29
3.1.5.4;Daytime Insomnia Symptom Questionnaires;29
3.1.6;Assessment of Anxiety;30
3.1.7;Structured Interviews for Anxiety;31
3.1.7.1;Clinician-Administered Interviews for Anxiety;31
3.1.7.2;Clinician-Administered Interviews for Specific Anxiety Disorders;31
3.1.7.3;Self-Report Measures for Anxiety Symptoms;32
3.1.7.4;General Measures for Self-Reported Anxiety;32
3.1.7.5;Anxiety Disorder-Specific Self-Report Questionnaires;33
3.1.8;Case Example 1: Generalized Anxiety Disorder and Insomnia;35
3.1.9;Case Example 2: Sleep-Specific Worry;36
3.2;References;37
4;Chapter 3;42
4.1;Anxiety Disorders and Accompanying Insomnia;42
4.1.1;Panic Disorder;42
4.1.2;Generalized Anxiety Disorder;44
4.1.3;Posttraumatic Stress Disorder: PTSD;46
4.1.4;Obsessive–Compulsive Disorder;49
4.1.5;Social Phobia;51
4.1.6;Specific Phobias;52
4.1.7;Summary;54
4.2;References;54
5;Chapter 4;59
5.1;Cognitive Behavior Therapy for Insomnia: Treatment Considerations;59
5.1.1;What is Cognitive Behavior Therapy and Who Can Benefit from It?;59
5.1.2;Cognitive Behavior Therapy Model;61
5.1.3;The Evidence Supporting CBT for Insomnia;63
5.1.4;Treatment Delivery Issues;64
5.2;References;67
6;Chapter 5;70
6.1;Medication Considerations;70
6.1.1;Will Cognitive Behavior Insomnia Therapy Work with Those Who Use Sleep Medications?;70
6.1.2;Prescription Hypnotics: Advantages and Disadvantages;72
6.1.3;Over-the-Counter Medications, Herbal Remedies, and Alternative Treatments;73
6.1.3.1;Antihistamine-Based Sleep Aids;74
6.1.3.2;Herbal Compounds and Dietary Supplements;75
6.1.3.3;Melatonin;75
6.1.3.4;Alcohol;76
6.1.4;Can Common Anxiety Medications Cause Insomnia Symptoms?;77
6.1.5;Combining Sleep Medications with CBT for Insomnia;78
6.1.6;Sleep Medication Discontinuation Strategies;80
6.2;References;82
7;Chapter 6;85
7.1;Behavioral Strategies for Managing Insomnia;85
7.1.1;Assessing the Sleep Problem Using the Sleep Diary;85
7.1.2;Setting the Stage for Treatment Recommendations: The Role of Psychoeducation;90
7.1.3;Presenting Behavioral Insomnia Treatment Recommendations;92
7.1.4;Addressing Sleep Hygiene Issues;95
7.1.5;The Value of Follow-Up Sessions;97
7.1.6;Assistance with TIB Changes;98
7.1.7;Reviewing/Reinforcing Adherence;99
7.1.8;Trouble-Shooting Problems;100
7.1.8.1;Case 1;101
7.1.8.2;Case 2;101
7.1.8.3;Case 3;102
7.2;References;103
8;Chapter 7;104
8.1;Sleep-Related Cognitive Processes;104
8.1.1;Harvey’s (2002) Cognitive Model;104
8.1.2;The Role of Thoughts;105
8.1.2.1;Unwanted Repetitive Mental Activity;106
8.1.3;The Role of Distress;107
8.1.4;Beliefs in Insomnia;107
8.1.5;Attention and the “Threat” of Sleep;108
8.1.6;The Role of Attributions;109
8.1.7;Maintaining the Status Quo;110
8.2;References;111
9;Chapter 8;114
9.1;Cognitive Strategies for Managing Anxiety and Insomnia;114
9.1.1;Worry Management Strategies;114
9.1.2;Constructive Worry Worksheet Example;116
9.1.3;Cognitive Restructuring;117
9.1.4;Thought Record;118
9.1.5;Decreasing Safety Behaviors and Behavioral Experiments;122
9.1.6;Focus on Relapse Prevention;124
9.1.7;Action Plan for Addressing Insomnia;124
9.1.8;Red Flags for a Possible Problem with Insomnia;125
9.1.9;What Tools Work for This Problem?;125
9.2;References;126
10;Chapter 9;128
10.1;Other Issues in Managing the Sleep of Those with Anxiety;128
10.1.1;Relaxation-Based Strategies;128
10.1.2;PMR Treatment Outline;131
10.1.3;Cognitive Behavioral Treatment of Nocturnal Panic;136
10.1.4;Craske’s Nocturnal Panic Protocol;136
10.1.5;Treating Claustrophobia Associated with Sleep Apnea Treatment;139
10.1.6;Dream/Nightmare Rescripting;143
10.1.7;Is it Time for a Sleep Specialist Consultation?;148
10.2;References;150