Adherence
Adapting Cognitive Behavioral Therapy for Insomnia (CBT-I) elements—specifically stimulus control, sleep restriction, and cognitive interventions—is the primary effective treatment for managing sleep problems during home confinement, with pharmacotherapy reserved only for short-term use when CBT-I is ineffective or unavailable.
Treat your sleep like a skill, not a switch. Go to bed only when you are sleepy, and get up at the same time every day, regardless of how much you slept. If you can't sleep, get out of bed and do something boring in dim light until you are sleepy again. Do not work, eat, or watch TV in bed. If stress is keeping you up, schedule 15 minutes earlier in the day to write down your worries, so they don't interfere with night-time sleep. Reserve medication for severe, short-term cases only, and only after trying these behavioral steps.
The European Academy for Cognitive-Behavioral Treatment of Insomnia (The European CBT-I Academy) was founded to improve accessibility to the most effective treatment for insomnia, cognitive behavioural therapy... Many elements of this treatment can be applied to the current situation, and may be adapted to treat and prevent sleep problems that result from confinement... The current European guideline for the diagnosis and treatment of insomnia (Riemann et al., 2017) recommends benzodiazepines (BZ) and hypnotic benzodiazepine receptor agonists (Z-drugs; HBRA) for short-term use as a second-line treatment if CBT-I treatment is ineffective or unavailable.
Why this rating
Based on a task force review of existing guidelines and studies, citing strong evidence for CBT-I in chronic and acute insomnia, though specific RCT data for COVID-19 confinement is limited to observational correlations.
Source
Dealing with sleep problems during home confinement due to the COVID‐19 outbreak: Practical recommendations from a task force of the European CBT‐I Academy
Ellemarije Altena et al. · Journal of Sleep Research · 2020
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