Behavioral sleep medicine

Behavioral Sleep Medicine

Behavioral Sleep Medicine (BSM) is a subfield of sleep medicine that investigates and addresses sleep-related disorders by focusing on the psychological, physiological, behavioral, cognitive, social, and cultural factors that influence sleep and are influenced by it. BSM is an evidence-based behavioral health discipline that primarily employs non-pharmacological treatments, meaning treatments that do not involve medications. BSM interventions are typically problem-focused and tailored to specific sleep complaints, and they can be integrated with other medical or mental health treatments, such as sleep apnea treatment or psychotherapy for mood disorders.

Overview

BSM integrates knowledge from various disciplines, including psychology, psychiatry, neurology, and behavioral sciences, to better understand and treat sleep disorders. The field aims to improve sleep quality and quantity, enhance daytime functioning, and address co-occurring medical or mental health issues.

Common Sleep Disorders Addressed in BSM

BSM is applicable to a wide range of sleep disorders, including:

• Insomnia
• Sleep apnea
• Restless legs syndrome
• Circadian rhythm sleep disorders
• Parasomnias
• Narcolepsy

BSM Interventions

BSM interventions are diverse and typically include the following approaches:

Cognitive Behavioral Therapy for Insomnia (CBT-I)

CBT-I is an evidence-based treatment for insomnia that targets the thoughts, behaviors, and habits contributing to sleep problems. Components of CBT-I may include:

• Sleep hygiene education
• Stimulus control therapy
• Sleep restriction therapy
• Cognitive therapy
• Relaxation training
• Biofeedback

Chronotherapy

Chronotherapy focuses on adjusting and stabilizing circadian rhythms, which can be particularly helpful for individuals with circadian rhythm sleep disorders. Techniques may include:

• Light therapy
• Dark therapy
• Phase shifting
• Regularizing sleep-wake schedules

Behavioral Treatment for Sleep Apnea

While medical treatments such as continuous positive airway pressure (CPAP) are commonly used for sleep apnea, BSM can complement these treatments by addressing factors that contribute to sleep apnea, such as:

• Weight management
• Sleep positioning
• Relaxation techniques to reduce anxiety and improve CPAP adherence

Pediatric Sleep Interventions

BSM can also address sleep disorders and sleep problems in children, such as bedtime resistance, night wakings, and sleep onset association disorder. Interventions may include:

• Parent training
• Graduated extinction
• Positive routines
• Scheduled awakenings
• Sleep education

Training and Certification

To become a BSM specialist, practitioners typically complete a formal education in a relevant discipline, such as psychology, psychiatry, or sleep medicine, followed by specialized training and clinical experience in BSM. Certification is available through organizations like the American Board of Sleep Medicine and the Society of Behavioral Sleep Medicine.

See also

• Sleep disorders
• Sleep medicine
• Cognitive behavioral therapy
• Circadian rhythm
• Sleep hygiene

Summary

Behavioral sleep medicine (BSM) is a field within sleep medicine that encompasses scientific inquiry and clinical treatment of sleep-related disorders, with a focus on the psychological, physiological, behavioral, cognitive, social, and cultural factors that affect sleep, as well as the impact of sleep on those factors. The clinical practice of BSM is an evidence-based behavioral health discipline that uses primarily non-pharmacological treatments (that is, treatments that do not involve medications). BSM interventions are typically problem-focused and oriented towards specific sleep complaints, but can be integrated with other medical or mental health treatments (such as medical treatment of sleep apnea, psychotherapy for mood disorders).

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