Dr Daniel Greer on Emergence of CBT as First-line Treatment for Chronic Insomnia

The minimal adverse effects of cognitive behavioral therapy (CBT) and its efficacy compared with medication have led to its recommendation as a first-line treatment for chronic insomnia, but access issues remain, said Daniel Greer, PharmD, BCPP, clinical assistant professor, Rutgers Ernest Mario School of Pharmacy.

Transcript

Can you speak on the emergence of CBT for chronic insomnia?

Emergence of CBT for chronic insomnia (CBT-I) goes back a little bit. So, when I look at guidelines from 2016, 2017, or even earlier guidelines than that, CBT-I is the first-line treatment for a few reasons.

One, it's been shown to be just as effective as medications are. And 2, there's a lot less side effects, and some would even say no side effects at all. Others say that for some people, their insomnia gets a little worse before it gets better, but other than that, there's no other systemic effects or side effects like there are with medications.

So, due to these reasons, CBT-I is promoted by the guidelines, the governing bodies, physicians, providers, so that's why there's been such an emergence of this type of therapy. The biggest issue really is access. We know CBT-I works, but there's not many providers specifically trained in how to administer CBT-I, so that's one of the biggest barriers: access.