Sleep-Wake Disorders Center - Behavioral Sleep Medicine Program - Insomnia - New York City - Montefiore Medical Center

Consequences of Insomnia
More than 1 in 4 people experience insomnia from time to time and more than 1 in 10 will suffer from a chronic form of insomnia. Untreated insomnia is associated with reduced quality of life, increased occurrence of accidents, risk for medical illness, and a risk for psychiatric illness.

What is Cognitive Behavior Therapy for Insomnia (CBT-I)?
CBT-I is an evidence-based, non-drug approach based upon the concept that chronic insomnia (lasting more than 4 weeks) is sustained by a variety of physica1and behavioral factors that are generally unrelated to acute insomnia (lasting one or two days). The factors that maintain chronic insomnia are the focus of the treatment.

What happens in Cognitive Behavior Therapy for Insomnia?
The experience of insomnia is unique to each person and is impacted by many factors including life circumstances, coping styles, and biological predispositions. Treatment is tailored to each patient's specific circumstances.

Treatment generally includes: education on the many factors that can interfere with sleep, developing healthy and effective sleep behaviors, learning skills for calming the mind and managing stress, individualized sleep-wake scheduling programs (including sleep consolidation and stimulus control) eliminating sleep-incompatible behaviors, and the use of properly timed light exposure to reset the sleep-wake body clock. These procedures are often complemented with relaxation training and cognitive therapy, based upon the treatment plan.

A goal of CBT-I is to teach patients tools they need to maintain improvements in sleep, particularly when they experience events that previously contributed to insomnia. Many patients even continue to sleep well months after they have completed the CBT-I appointments with their clinician.

Clinical studies have shown CBT-I is highly effective for the treatment of insomnia, producing long lasting results that are comparable to, or exceed, those of sleeping pills. Many now consider CBT to be the "gold standard" for the treatment of insomnia, saving significant medication costs for the consumer.

How long does Cognitive Behavior Therapy for Insomnia take and what does it cost?
Although each person's situation is unique, on average 4 to 12 sessions are usually required to get people to begin sleeping well and to help them continue sleeping well. Follow-up recommendations are made to ensure that the results are maintained.

The services provided by the Cognitive Behavior Therapy Program are listed by health insurance companies as mental health/behavioral health codes. Our office staff will be able to help you figure out what out of pocket expenses, if any, you will need to pay, as determined by your health insurance plan.

What if I am on medication?
You do not have to be off of medication to benefit from CBT-I. Although many people choose to begin our program without medication, a number of people decide to start our program as a way to learn strategies that will complement their current sleep aids. If you do decide, however, to stop your medication during your treatment, we will work with you and your prescribing doctor to gradually taper your dosage once you feel comfortable doing so and have learned alternative techniques.

WE ALSO OFFER GROUP COGNITIVE BEHAVIOR THERAPY FOR INSOMIA

Our group treatment consists of seven 90-minute sessions conducted over nine weeks. Although treatment is provided in a group setting, each patient receives an individualized set of recommendations that are tailored to fit his/her needs, goals and circumstances.

What is the benefit of attending group treatment as opposed to individual treatment?
Numerous research studies have shown that group treatment is equally as effective as individual treatment for insomnia. There is generally a much shorter wait list to get treatment. In addition, many group members find it invaluable to hear from other people who are currently dealing with similar sleep difficulties and everyone can share advice as to how they are working with the treatment recommendations.

What if I can't attend all of the group sessions?
It is strongly suggested that you do not miss any sessions, since each treatment component builds upon the one introduced the week before. You will get the best results if you attend all sessions. The fee for an individual session is higher than group sessions. However, if you are unable to attend a session, you can schedule an individual appointment with a staff psychologist in order to catch up on missed material.

What is the age range and size of the group?
We work with adults of all ages. The size of the group ranges from 7 to 10 members.

For more information, please call 718-920-4841 and ask about the Cognitive Behavior Therapy Program.