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BOSTON—In an attempt to be supportive, bed partners of patients with insomnia may engage in behaviors that unintentionally perpetuate insomnia, according to preliminary results presented at the 31st Annual Meeting of the Associated Professional Sleep Societies. Bed partners also may make accommodations that affect their own sleep and life outside of work.
“It is possible that partners are unwittingly perpetuating insomnia symptoms in the patient with insomnia,” said Alix Mellor, PhD, a postdoctoral research fellow and coordinator of the Researching Effective Sleep Treatments (REST) project in the School of Psychological Sciences at Monash University in Victoria, Australia. “It is therefore important for more data to be collected to determine whether insomnia treatments may better benefit patients and their partners by proactively assessing and addressing bed partner behaviors in treatment programs.” 
Relationship problems and mismatched bedtimes and wake times within couples have been linked to insomnia. Research in disorders such as obsessive–compulsive disorder (OCD) and depression indicates that partners can reinforce maladaptive behaviors inadvertently. No data have documented the specific behaviors engaged in by partners of individuals with insomnia, however, and these behaviors might perpetuate the disorder.
Partners Encouraged Early Bedtimes
In a randomized controlled trial investigating partner-assisted interventions for insomnia, Dr. Mellor and colleagues studied 31 bed partners (14 women) of patients seeking treatment for insomnia. At baseline, partners completed the Family Accommodation Scale for OCD, Beck Anxiety Inventory, and Dyadic Adjustment Scale. Patients with insomnia completed the Insomnia Severity Index and other questionnaires at baseline and kept a sleep diary for one week prior to treatment initiation.
Approximately 74% of bed partners encouraged an early bedtime or late wake time, which directly contradicts the principles of cognitive behavioral therapy for insomnia (CBT-I). In addition, 42% of bed partners encouraged doing other things in bed, such as reading or watching TV, and 35% encouraged naps, caffeine, or reduced daytime activities. About 11% encouraged their partners to take sleep medication or alcohol to improve sleep. About 56% of bed partners reported that their partner becomes distressed when they do not provide assistance with their insomnia.
Half of bed partners adjusted their own sleep. Furthermore, 39% of bed partners adjusted their family routine, and half modified their leisure activities in response to their partners’ insomnia. Approximately 17% modified their work schedule. The bed partners who attempted to be helpful experienced more anxiety, even though the patients with insomnia perceived the relationship to be more satisfying.
Neurologists Could Explain Principles Behind Treatment
“If neurologists are using behavioral interventions like CBT-I, our findings suggest they should ask their patients about a few specific things their partner might do to unintentionally undermine the treatment,” said Sean P.A. Drummond, PhD, Professor of Clinical Neuroscience at Monash University and lead investigator of this study. “The neurologist should take the time to make sure the patient knows why those things are incompatible with treatment and encourage the patient to explain those ideas to the partner. An extra bonus would be if the patient could ask the partner for help in making sure they follow the treatment guidelines.”
Dr. Drummond and colleagues are studying a form of CBT-I that incorporates assistance from a partner. “We are explicitly incorporating the partner into the intervention in an effort to improve outcomes,” said Dr. Drummond.
—Erik Greb
Suggested Reading
Ellis JG, Deary V, Troxel WM. The role of perceived partner alliance on the efficacy of CBT-I: preliminary findings from the Partner Alliance in Insomnia Research Study (PAIRS). Behav Sleep Med. 2015;13(1):64-72.
McCall WV. Cognitive behavioral therapy for insomnia (CBT-I): What is known, and advancing the science by avoiding the pitfalls of the placebo effect. Sleep Med Rev. 2017 May 5 [Epub ahead of print].
Rogojanski J, Carney CE, Monson CM. Interpersonal factors in insomnia: a model for integrating bed partners into cognitive behavioral therapy for insomnia. Sleep Med Rev. 2013;17(1):55-64.
van Straten A, van der Zweerde T, Kleiboer A, et al. Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis. Sleep Med Rev. 2017 Feb 9 [Epub ahead of print].
BOSTON—In an attempt to be supportive, bed partners of patients with insomnia may engage in behaviors that unintentionally perpetuate insomnia, according to preliminary results presented at the 31st Annual Meeting of the Associated Professional Sleep Societies. Bed partners also may make accommodations that affect their own sleep and life outside of work.
“It is possible that partners are unwittingly perpetuating insomnia symptoms in the patient with insomnia,” said Alix Mellor, PhD, a postdoctoral research fellow and coordinator of the Researching Effective Sleep Treatments (REST) project in the School of Psychological Sciences at Monash University in Victoria, Australia. “It is therefore important for more data to be collected to determine whether insomnia treatments may better benefit patients and their partners by proactively assessing and addressing bed partner behaviors in treatment programs.”
Relationship problems and mismatched bedtimes and wake times within couples have been linked to insomnia. Research in disorders such as obsessive–compulsive disorder (OCD) and depression indicates that partners can reinforce maladaptive behaviors inadvertently. No data have documented the specific behaviors engaged in by partners of individuals with insomnia, however, and these behaviors might perpetuate the disorder.
Partners Encouraged Early Bedtimes
In a randomized controlled trial investigating partner-assisted interventions for insomnia, Dr. Mellor and colleagues studied 31 bed partners (14 women) of patients seeking treatment for insomnia. At baseline, partners completed the Family Accommodation Scale for OCD, Beck Anxiety Inventory, and Dyadic Adjustment Scale. Patients with insomnia completed the Insomnia Severity Index and other questionnaires at baseline and kept a sleep diary for one week prior to treatment initiation.
Approximately 74% of bed partners encouraged an early bedtime or late wake time, which directly contradicts the principles of cognitive behavioral therapy for insomnia (CBT-I). In addition, 42% of bed partners encouraged doing other things in bed, such as reading or watching TV, and 35% encouraged naps, caffeine, or reduced daytime activities. About 11% encouraged their partners to take sleep medication or alcohol to improve sleep. About 56% of bed partners reported that their partner becomes distressed when they do not provide assistance with their insomnia.
Half of bed partners adjusted their own sleep. Furthermore, 39% of bed partners adjusted their family routine, and half modified their leisure activities in response to their partners’ insomnia. Approximately 17% modified their work schedule. The bed partners who attempted to be helpful experienced more anxiety, even though the patients with insomnia perceived the relationship to be more satisfying.
Neurologists Could Explain Principles Behind Treatment
“If neurologists are using behavioral interventions like CBT-I, our findings suggest they should ask their patients about a few specific things their partner might do to unintentionally undermine the treatment,” said Sean P.A. Drummond, PhD, Professor of Clinical Neuroscience at Monash University and lead investigator of this study. “The neurologist should take the time to make sure the patient knows why those things are incompatible with treatment and encourage the patient to explain those ideas to the partner. An extra bonus would be if the patient could ask the partner for help in making sure they follow the treatment guidelines.”
Dr. Drummond and colleagues are studying a form of CBT-I that incorporates assistance from a partner. “We are explicitly incorporating the partner into the intervention in an effort to improve outcomes,” said Dr. Drummond.
—Erik Greb
Suggested Reading
Ellis JG, Deary V, Troxel WM. The role of perceived partner alliance on the efficacy of CBT-I: preliminary findings from the Partner Alliance in Insomnia Research Study (PAIRS). Behav Sleep Med. 2015;13(1):64-72.
McCall WV. Cognitive behavioral therapy for insomnia (CBT-I): What is known, and advancing the science by avoiding the pitfalls of the placebo effect. Sleep Med Rev. 2017 May 5 [Epub ahead of print].
Rogojanski J, Carney CE, Monson CM. Interpersonal factors in insomnia: a model for integrating bed partners into cognitive behavioral therapy for insomnia. Sleep Med Rev. 2013;17(1):55-64.
van Straten A, van der Zweerde T, Kleiboer A, et al. Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis. Sleep Med Rev. 2017 Feb 9 [Epub ahead of print].
BOSTON—In an attempt to be supportive, bed partners of patients with insomnia may engage in behaviors that unintentionally perpetuate insomnia, according to preliminary results presented at the 31st Annual Meeting of the Associated Professional Sleep Societies. Bed partners also may make accommodations that affect their own sleep and life outside of work.
“It is possible that partners are unwittingly perpetuating insomnia symptoms in the patient with insomnia,” said Alix Mellor, PhD, a postdoctoral research fellow and coordinator of the Researching Effective Sleep Treatments (REST) project in the School of Psychological Sciences at Monash University in Victoria, Australia. “It is therefore important for more data to be collected to determine whether insomnia treatments may better benefit patients and their partners by proactively assessing and addressing bed partner behaviors in treatment programs.”
Relationship problems and mismatched bedtimes and wake times within couples have been linked to insomnia. Research in disorders such as obsessive–compulsive disorder (OCD) and depression indicates that partners can reinforce maladaptive behaviors inadvertently. No data have documented the specific behaviors engaged in by partners of individuals with insomnia, however, and these behaviors might perpetuate the disorder.
Partners Encouraged Early Bedtimes
In a randomized controlled trial investigating partner-assisted interventions for insomnia, Dr. Mellor and colleagues studied 31 bed partners (14 women) of patients seeking treatment for insomnia. At baseline, partners completed the Family Accommodation Scale for OCD, Beck Anxiety Inventory, and Dyadic Adjustment Scale. Patients with insomnia completed the Insomnia Severity Index and other questionnaires at baseline and kept a sleep diary for one week prior to treatment initiation.
Approximately 74% of bed partners encouraged an early bedtime or late wake time, which directly contradicts the principles of cognitive behavioral therapy for insomnia (CBT-I). In addition, 42% of bed partners encouraged doing other things in bed, such as reading or watching TV, and 35% encouraged naps, caffeine, or reduced daytime activities. About 11% encouraged their partners to take sleep medication or alcohol to improve sleep. About 56% of bed partners reported that their partner becomes distressed when they do not provide assistance with their insomnia.
Half of bed partners adjusted their own sleep. Furthermore, 39% of bed partners adjusted their family routine, and half modified their leisure activities in response to their partners’ insomnia. Approximately 17% modified their work schedule. The bed partners who attempted to be helpful experienced more anxiety, even though the patients with insomnia perceived the relationship to be more satisfying.
Neurologists Could Explain Principles Behind Treatment
“If neurologists are using behavioral interventions like CBT-I, our findings suggest they should ask their patients about a few specific things their partner might do to unintentionally undermine the treatment,” said Sean P.A. Drummond, PhD, Professor of Clinical Neuroscience at Monash University and lead investigator of this study. “The neurologist should take the time to make sure the patient knows why those things are incompatible with treatment and encourage the patient to explain those ideas to the partner. An extra bonus would be if the patient could ask the partner for help in making sure they follow the treatment guidelines.”
Dr. Drummond and colleagues are studying a form of CBT-I that incorporates assistance from a partner. “We are explicitly incorporating the partner into the intervention in an effort to improve outcomes,” said Dr. Drummond.
—Erik Greb
Suggested Reading
Ellis JG, Deary V, Troxel WM. The role of perceived partner alliance on the efficacy of CBT-I: preliminary findings from the Partner Alliance in Insomnia Research Study (PAIRS). Behav Sleep Med. 2015;13(1):64-72.
McCall WV. Cognitive behavioral therapy for insomnia (CBT-I): What is known, and advancing the science by avoiding the pitfalls of the placebo effect. Sleep Med Rev. 2017 May 5 [Epub ahead of print].
Rogojanski J, Carney CE, Monson CM. Interpersonal factors in insomnia: a model for integrating bed partners into cognitive behavioral therapy for insomnia. Sleep Med Rev. 2013;17(1):55-64.
van Straten A, van der Zweerde T, Kleiboer A, et al. Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis. Sleep Med Rev. 2017 Feb 9 [Epub ahead of print].