Intensive sleep deprivation and cognitive behavioral therapy for pharmacotherapy refractory insomnia in a hospitalized patient

Joshua Breitstein, Brandon Penix, Bernard J. Roth, Tristin Baxter, Vincent Mysliwiec

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

The case of a 59-year-old woman psychiatrically hospitalized with comorbid insomnia, suicidal ideation, and generalized anxiety disorder is presented. Pharmacologic therapies were unsuccessful for treating insomnia prior to and during hospitalization. Intensive sleep deprivation was initiated for 40 consecutive hours followed by a recovery sleep period of 8 hours. Traditional components of cognitive behavioral therapy for insomnia (CBTi), sleep restriction, and stimulus control therapies, were initiated on the ward. After two consecutive nights with improved sleep, anxiety, and absence of suicidal ideation, the patient was discharged. She was followed in the sleep clinic for two months engaging in CBTi. Treatment resulted in substantial improvement in her insomnia, daytime sleepiness, and anxiety about sleep. Sleep deprivation regimens followed by a restricted sleep recovery period have shown antidepressant effects in depressed patients. Similar treatment protocols have not been investigated in patients with pharmacotherapy refractory insomnia and generalized anxiety disorder.

Original languageEnglish (US)
Pages (from-to)689-690
Number of pages2
JournalJournal of Clinical Sleep Medicine
Volume10
Issue number6
DOIs
StatePublished - 2014
Externally publishedYes

Keywords

  • Anxiety
  • Depression
  • Hypnotics
  • Insomnia
  • Sleep deprivation
  • Sleep restriction therapy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

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