Complementary and Integrative Health Interventions for Insomnia in Veterans and Military Populations

2021 ◽  
pp. 003329412110484
Author(s):  
Julie K. Staples ◽  
Courtney Gibson ◽  
Madeline Uddo
Keyword(s):  
Sleep Disturbances ◽  
Tai Chi ◽  
Mindfulness Meditation ◽  
Behavioral Therapy ◽  
Hippocampal Volume ◽  
Gamma Aminobutyric Acid ◽  
Integrative Health ◽  
Acid Acid ◽  
Military Populations

Insomnia can be a serious problem diminishing quality of life for Veterans and military populations with and without posttraumatic stress disorder (PTSD). Sleep disturbances are one of the symptoms of PTSD but even after evidence-based PTSD treatments, insomnia symptoms often remain. The primary approaches for treating insomnia are cognitive behavioral therapy for insomnia (CBT-I) and pharmacotherapy. However, each of these treatments has drawbacks. Complementary and Integrative Health (CIH) approaches such as mindfulness meditation, mantram meditation, yoga, and tai chi may provide alternative treatments for insomnia in military populations. This paper provides a brief review of studies on CIH interventions for sleep disturbances in Veterans. It also proposes possible mechanisms by which CIH practices may be effective, including increasing hippocampal volume and gamma-aminobutyric acid acid (GABA). Finally, the acceptability of CIH approaches among Veterans is discussed.

Insomnia and Integrative Therapies

2021 ◽  
pp. 397-418
Author(s):  
Robert Maurer ◽  
Param Dedhia
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Electrical Stimulation ◽  
Tai Chi ◽  
Behavioral Therapy ◽  
Therapeutic Approaches ◽  
Heart Rate Variability Biofeedback ◽  
Definition Of ◽  
Integrative Therapies

Because sleep and health are innately connected, insomnia is among the most common challenges to both the quantity and quality of sleep. In addition to developing an understanding of insomnia, available therapies must be examined. Although of the treatment discussions for sleep disorders have relied on pharmacology, these are often not effective or challenged by untoward side effects. Therefore approaches beyond medications are needed. This chapter explores the definition of insomnia and therapeutic approaches focused on cognitive-behavioral therapy for insomnia (CBT-I), mindfulness-based therapies for insomnia (MBTI), yoga, tai chi, heart rate variability, biofeedback, electrical stimulation, exercise, and nutrition.

Professionally Directed Non-Pharmacological Management of Chronic Pain (DRAFT)

2018 ◽  
Author(s):  
Peter Przekop
Keyword(s):  
Chronic Pain ◽  
Support Groups ◽  
Tai Chi ◽  
Relaxation Training ◽  
Mindfulness Meditation ◽  
Behavioral Therapy ◽  
Medication Management ◽  
Qi Gong ◽  
Pharmacological Management ◽  
Psychosocial Treatments

This chapter is a complement to Chapter 15, concentrating on the non-pharmacological approaches to chronic pain. It features a discussion on the utility of mind-body therapies, psychosocial treatments, and technology-based therapies in the context of recovery through 12-Step programs and other mutual support groups. Such settings are commonly poorly receptive to medication management of either pain or addiction; the availability of other approaches can bridge the gap, leading to effective management of both. The therapies discussed include “movement” therapies, such as internal qi gong, tai chi, yoga, and martial arts. Healing touch, reiki, external qi gong, and acupuncture are examples of “energy” therapies, requiring an intercessor. Among the psychosocial treatments are motivational interviewing, cognitive restructuring, cognitive behavioral therapy, acceptance-based cognitive therapy, operant training, hypnosis, relaxation training, and mindfulness/meditation. Addressed as procedures are massage, chiropractic and osteopathic manipulations, trans-epidermal nerve stimulation (TENS), and transcranial magnetic stimulation (TMS).

scholarly journals Sleep disorders in acute and chronic pain

2021 ◽  
Vol 13 (3) ◽  
pp. 125-130
Author(s):  
M. G. Poluektov ◽  
A. O. Golovatyuk
Keyword(s):  
Sleep Disorders ◽  
Sleep Duration ◽  
Sleep Disturbances ◽  
Behavioral Therapy ◽  
Experimental Studies ◽  
Pain Sensation ◽  
Analgesic Effects ◽  
Pain Syndromes ◽  
Insomnia Treatment

Pain is one of the leading causes of decline in quality of life. When pain syndromes occur, a person may experience unpleasant sensory sensations and concomitant disorders, which can lead to pain aggravation and sleep disturbances. According to experimental studies, increased pain sensation with reduced sleep duration occurs due to opioid, serotonergic, noradrenergic, and dopaminergic antinociceptive systems dysfunction. In clinical practice, a reduction in sleep duration is usually associated with insomnia, which is the most common sleep disorder. In pain syndromes, insomnia occurs in 53–90% of patients (for comparison: in the general population – in 7.4%). Non-pharmacological (cognitive-behavioral therapy) and pharmacological approaches are used in insomnia treatment. Some medications (amitriptyline, mirtazapine, trazodone, gabapentin, pregabalin) have both hypnotic and analgesic effects, which allows to use them for pain syndromes with sleep disturbances. It has been shown that the correction of sleep disorders can reduce the severity and frequency of pain.

Insomnia and Clinical Sleep Disturbance in Later Life

2019 ◽  
Author(s):  
Simon Smith
Keyword(s):  
Psychological Health ◽  
Sleep Disturbances ◽  
Behavioral Therapy ◽  
Later Life ◽  
Poor Sleep ◽  
Sleep Health ◽  
Reasonable Expectation ◽  
Key Factor ◽  
Good Sleep

Sleep health is understood as a key factor in lifelong health and for social participation, function, and satisfaction. In later life, insomnia and other sleep disturbances are common. Insomnia is experienced as poor, disrupted, or insufficient sleep associated with significant daytime impairments including increased fatigue or reduced energy, impaired cognitive function, and increased mood disturbance. Poor sleep is associated with negative outcomes across a range of dimensions that impair quality of life, increases risk for other diseases, and may interact negatively with the progression and treatment of other disorders. Evidence for effective psychological interventions to improve sleep in later life, specifically cognitive behavioral therapy for insomnia, is robust and well described. Good sleep should be understood as a substrate for psychological health and a reasonable expectation in later life.

Integrative Sleep Medicine and Chronic Pain Management

2021 ◽  
pp. 433-448
Author(s):  
Ashwin Mehta
Keyword(s):  
Chronic Pain ◽  
Sleep Disturbances ◽  
Tai Chi ◽  
Behavioral Therapy ◽  
Treatment Strategies ◽  
Chronic Pain Management ◽  
Comprehensive Management ◽  
Physical Discomfort ◽  
Nonrestorative Sleep ◽  
Bidirectional Relationship

Widespread opioid dependency has spurred growing interest in nonpharmacologic methods of addressing chronic pain. Timely research has established a reciprocal and bidirectional relationship between physical discomfort and sleep disturbances. Thus, comprehensive management of chronic pain necessitates a thorough sleep evaluation because underlying sleep concerns can often thwart otherwise effective treatment strategies. Interventions such as cognitive-behavioral therapy are useful to loosen the psychologic association patients commonly form between chronic pain and nonrestorative sleep. Exercise and mindfulness are among those modalities with the best evidence to simultaneously address both sleep loss and chronic pain. Acupuncture, yoga, and tai chi, as well as certain herbs, can be used to stem the inflammatory cascade that frequently hinders successful treatment. Integrative approaches that promote restful sleep are of increasing importance in the context of managing chronic pain.

scholarly journals Depression and sleep: pathophysiology and treatment

2006 ◽  
Vol 8 (2) ◽  
pp. 217-226 ◽  
Keyword(s):  
Sleep Disturbances ◽  
Depressive Disorders ◽  
Slow Wave Sleep ◽  
Behavioral Therapy ◽  
Adjunctive Treatment ◽  
Gamma Aminobutyric Acid ◽  
Gaba A ◽  
Sleep Maintenance ◽  
Disturbed Sleep ◽  
Normal Sleep

This review examines the relationship between sleep and depression. Most depressive disorders are characterized by subjective sleep disturbances, and the regulation of sleep is intricately linked to the same mechanisms that are implicated in the pathophysiology of depression. After briefly reviewing the physiology and topography of normal sleep, the disturbances revealed in studies of sleep in depression using polysomnographic recordings and neuroimaging assessments are discussed. Next, treatment implications of the disturbances are reviewed at both clinical and neurobiologic levels. Most antidepressant medications suppress rapid eye movement (REM) sleep, although this effect is neither necessary nor sufficient for clinical efficacy. Effects on patients' difficulties initiating and maintaining sleep are more specific to particular types of antidepressants. Ideally, an effective antidepressant will result in normalization of disturbed sleep in concert with resolution of the depressive syndrome, although few interventions actually restore decreased slow-wave sleep. Antidepressants that block central histamine 1 and serotonin 2 tend to have stronger effects on sleep maintenance, but are also prone to elicit complaints of daytime sedation. Adjunctive treatment with sedative hypnotic medications--primarily potent, shorter-acting benzodiazepine and gamma-aminobutyric acid (GABA A)-selective compounds such as zolpidem--are often used to treat associated insomnia more rapidly. Cognitive behavioral therapy and other nonpharmacologic strategies are also helpful.

scholarly journals Mindfulness Meditation and Tai Chi Chuan on Sleep Disturbance in Chinese Older People: A Randomized Controlled Trial

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 188-189
Author(s):  
Sunny Chan ◽  
Wai Chi Chan ◽  
Siu Man Ng ◽  
Chong Ho Alex Yu
Keyword(s):  
Health Status ◽  
Older People ◽  
Sleep Disturbance ◽  
Sleep Disturbances ◽  
Tai Chi ◽  
Mindfulness Meditation ◽  
Community Dwelling ◽  
Control Group ◽  
Tai Chi Chuan ◽  
Randomized Controlled

Abstract Sleep disturbances are common during the aging process and can result in a reduced quality of life. Many older people who experience sleep disturbances would consider turning to complementary and alternative medicine (CAM) due to the limitations of traditional pharmaceutical or psychological and behavioural treatments. Mindfulness Meditation (MM) and Tai Chi Chuan (TCC) are two common forms of mind-body based CAM. The former focuses more on mind-based practices whereas the latter emphasizes predominantly on body or movement-based practices. An etiological model of sleep disturbance (Shallcross et al., 2019) can lay the groundwork for a better understanding of the mechanisms of MM and TCC in relation to sleep disturbances. This study aims at comparing the effects of MM and TCC with Sleep Hygiene Education (SHE) control group. A three-armed randomized controlled pilot trial was conducted involving 45 community-dwelling older adults aged 65 to 82 with symptoms of sleep disturbance. Moderate effect sizes (Cohen’s d = 0.7 and 0.56) were found for the primary outcome of insomnia severity at post-intervention as comparing MM and TCC groups with SHE control group, respectively. More specific, participants in the MM group showed more amelioration on mental health status, introspective awareness, and objective measure of EEG-based brain arousal level; whereas participants in the TCC group showed better improvement on physical health status and subjective measure of hyperarousal. Findings demonstrate the unique therapeutic effects of MM and TCC on improving sleep problem in older people. The application in a Chinese context will be discussed.

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