[Psychological, psychotherapeutic and other non-pharmacologic forms of therapy in treatment of insomnia. Position of the "Insomnia" Study Group of the German Society of Sleep Research and Sleep Medicine]

Abstract

Psychological and psychotherapeutic techniques are an essential part of the treatment of insomnia. Mainly two facts stress the importance of psychological/psychotherapeutical strategies for insomnia: (1) Concepts for non-drug treatment aim at improvement of the symptoms and the underlying cause of the disease and (2) disadvantages of hypnotic therapy such as substance abuse or addiction are avoided. Effective treatment techniques such as patients education and counseling, sleep hygiene, stimulus control and relaxation techniques should be known to every therapist, especially general practitioners who treat the majority of patients haring difficulties in initiating or maintaining sleep. Several other effective behavioural techniques, e.g. sleep restriction, or cognitive therapy, and psychotherapy should be used only by skilled and trained experts. Insomniacs with chronic and severe complaints should be treated by therapists with experience in sleep medicine. Multimodal treatment strategies are provided for by sleep disorder centres and combine effective treatment elements in structured therapeutic concepts. There is absolute consensus of opinion that every hypnotic treatment of an insomniac patient should be combined with basal elements of non-drug treatment strategies.