Skip to main content
SpringerLink
Log in

Other Issues in Managing the Sleep of Those with Anxiety

  • Chapter
  • First Online:
Insomnia and Anxiety

Part of the book series: Series in Anxiety and Related Disorders ((SARD))

  • 2258 Accesses

Abstract

We have presented the core treatment strategies of CBT for insomnia in the previous chapters, but there are potential challenges unique to those suffering from comorbid anxiety problems that should be discussed. Herein, we present specific instructions/protocols for managing sleep problems in the context of anxiety and anxiety disorders, including relaxation-based strategies (focusing specifically on Progressive Muscle Relaxation), Cognitive Behavioral Treatment of Nocturnal Panic (Craske et al., Behavior Therapy 36:43-54, 2005), treating claustrophobia for those using CPAP for sleep apnea, and dream/nightmare rescripting. While a major goal of this text is that of providing practitioners guidance in the use of psychological strategies for the management of sleep problems with anxiety as a prominent feature, the problems discussed may represent only a subset of the varied forms of sleep disturbances that may present as primary or comorbid sleep disorders. Many people with such conditions require and benefit from one or more consultations with a sleep specialist. Hence, we provide discussion and a resource for use in determining whether the type of sleep problem and circumstances warrant a sleep specialty referral.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Aloia, M., Arnedt, J., Riggs, R., Hecht, J., & Borrelli, B. (2004). Clinical management of poor adherence to CPAP: Motivational enhancement. Behavioral Sleep Medicine, 2, 205–222.

    Article  PubMed  Google Scholar 

  • Beecroft, J., Zanon, S., Lukic, D., & Hanly, P. (2003). Oral continuous positive airway pressure for sleep apnea: Effectiveness, patient preference, and adherence. Chest, 124, 2200–2208.

    Article  PubMed  Google Scholar 

  • Benson, H. (1984). Beyond the relaxation response: How to harness the healing power of your personal beliefs. New York: Berkley Books.

    Google Scholar 

  • Bernstein, D., & Borkovec, T. D. (1973). Progressive relaxation training. Champaign, Ill: Research Press.

    Google Scholar 

  • Berquier, A., & Ashton, R. (1992). Characteristics of the frequent nightmare sufferer. Journal of Abnormal Psychology, 101, 246–250.

    Article  PubMed  Google Scholar 

  • Bishay, N. (1985). Therapeutic manipulation of nightmares and the management of neuroses. British Journal of Psychaitry, 147, 67–70.

    Article  Google Scholar 

  • Bixler, E., Kales, A., & Soldatos, C. (1979). Sleep disorder encountered in medical practice: A national survey. Behavioral Medicine, 6, 13–21.

    Google Scholar 

  • Borkovec, T. D., & Fowles, D. C. (1973). Controlled investigation of the effects of progressive relaxation and hypnotic relaxation on insomnia. Journal of Abnormal Psychology, 82, 153–158.

    Article  PubMed  Google Scholar 

  • Brylowski, A. (1990). Nightmares in crisis: Clinical applications of lucid dreaming techniques. Psychiatry Journal of the University of Ottawa, 15, 79–84.

    Google Scholar 

  • Cartwright, R., Young, M., Mercer, P., & Bears, M. (1998). Role of REM sleep and dream variables in prediction of remission from depression. Psychiatry Research, 80, 249–255.

    Article  PubMed  Google Scholar 

  • Cellucci, A., & Lawrence, P. (1978). The efficacy of systematic desensitization in reducing nightmares. Journal of Behavior Therapy and Experimental Psychiatry, 9, 109–114.

    Article  Google Scholar 

  • Cernovsky, Z. (1985). MMPI and nightmares in male alcoholics. Perceptual and Motor Skills, 61, 841–842.

    PubMed  Google Scholar 

  • Cernovsky, Z. (1986). MMPI and nightmares reports in women addicted to alcohol and other drugs. Perceptual and Motor Skills, 62, 717–718.

    PubMed  Google Scholar 

  • Chasens, E. R., Pack, A., Maislin, G., Dinges, D., & Weaver, T. (2005). Claustrophobia and adherence to CPAP treatment. Western Journal of Nursing Research, 27, 307–321.

    Article  PubMed  Google Scholar 

  • Clum, G., Clum, G., & Surls, R. (1993). A meta-analysis of treatments for panic disorder. Journal of Consulting and Clinical Psychology, 61(2), 317–326.

    Article  PubMed  Google Scholar 

  • Connor, K. M., Davidson, J. R., Churchill, L. E., Sherwood, A., Foa, E. B., & Weisler, R. H. (2000). Psychometric properties of the Social Phobia Inventory (SPIN): A new self-rating scale. British Journal of Psychiatry, 176, 379–386.

    Article  PubMed  Google Scholar 

  • Craske, M. G., Lang, A. J., Aikins, D., & Mystkowski, J. L. (2005). Cognitive behavioral therapy for nocturnal panic. Behavior Therapy, 36, 43–54.

    Article  Google Scholar 

  • Edinger, J., Wohlgemuth, W., Radtke, R., Marsh, G., & Quillian, R. (2001). Cognitive behavioral therapy for treatment of chronic Primary Insomnia: A randomized controlled trial. The Journal of the American Medical Association, 285, 1856–1864.

    Article  Google Scholar 

  • Edinger, J. D., & Radtke, R. A. (1993). Use of in vivo desensitization to treat a patient’s claustrophobic response to nasal CPAP. Sleep, 16(7), 678–680.

    PubMed  Google Scholar 

  • Engleman, H., & Wild, M. (2003). Improving CPAP use by patients with the sleep apnoea/hypopnoea syndrome (SAHS). Sleep Medicine Reviews, 7, 81–99.

    Article  PubMed  Google Scholar 

  • Foa, E., Riggs, D., Dancu, C., & Rothmaum, B. (1993). Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. Journal of Traumatic Stress, 6, 459–473.

    Article  Google Scholar 

  • Forbes, D., Creamer, M., & Biddle, D. (2001). The validity of the PTSD checklist as a measurs of symptomatic change in combat-related PTSD. Behaviour Research and Therapy, 39, 977–986.

    Article  PubMed  Google Scholar 

  • Forbes, D., Phelps, A., McHugh, A., Debenham, P., Hopwood, M., & Creamer, M. (2003). Imagery rehearsal in the treatment of posttraumatic nightmares in Australian Veterans with chronic combat-related PTSD: 12-month follow-up data. Journal of Traumatic Stress, 16(5), 509–513.

    Article  PubMed  Google Scholar 

  • Forbes, D., Phelps, A., & McHugh, T. (2001). Treatment of combat-related nightmares using imagery rehearsal therapy: A pilot study. Journal of Traumatic Stress, 14(2), 433–442.

    Article  PubMed  Google Scholar 

  • Futterman, A., & Shapiro, D. (1986). A review of biofeedback for mental disorders. Hospital and Community Psychiatry, 37(1), 27–33.

    PubMed  Google Scholar 

  • Grunstein, R., & Sullivan, C. (2000). Continuous positive airway pressure for slep breathing disorders. In M. Kryger, T. Roth, & W. Dement (Eds.), Principles and practice of sleep medicine (3rd ed., pp. 894–912). Philadelphia: W. B. Saunders Company.

    Google Scholar 

  • Hartmann, E. (1984). The nightmare: The psychology and biology of terrifying drams. New York: Basic Books.

    Google Scholar 

  • Jacobson, E. (1964). Anxiety and tension control. Philadelphia: Lippincott.

    Google Scholar 

  • Jenkins, N., Mrad, R., & Walsh, J. (1991). Long term nasal CPAP use and follow-up care. Sleep Research, 20, 56.

    Google Scholar 

  • Jorm, A., Christensen, H., Griffiths, K., Parslow, R., Rodgers, B., & Blewitt, K. (2004). Effectiveness of complementary and self-help treatments for anxiety disorders. Medical Journal of Australia, 181(7 suppl.), S29–S46.

    PubMed  Google Scholar 

  • Kales, A., Soldatos, C., & Caldwell, A. B. (1980). Nightmares: Clinical characteristics and personality patterns. American Journal of Psychiatry, 137, 1197–1201.

    PubMed  Google Scholar 

  • Kilpatrick, D., Resnick, H., Freedy, J., Pelcovitz, D., Resick, P., & Roth, S. (1998). Posttraumatic stress disorder field trial: evaluation of the PTSD construct-criteria A through E. In T. Widiger & A. Frances (Eds.), DSM-IV sourcebook. Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Koontz, K. L., Slifer, K. J., Cataldo, M. D., & Marcus, C. L. (2003). Improving pediatric compliance with positive airway pressure therapy: The impact of behavioral intervention. Sleep, 26, 1010–1015.

    PubMed  Google Scholar 

  • Krakow, B., Hollifield, M., Johnson, L., Koss, M., Schrader, R., Warner, T., et al. (2001). Imagery rehearsal therapy for chronic nightmares in sexual assault survivors with posttraumatic stress disorder: A randomized controlled trial. The Journal of the American Medical Association, 286, 537–545.

    Article  Google Scholar 

  • Krakow, B., Hollifield, M., Schrader, R., Koss, M., Tandberg, D., Lauriello, J., et al. (2000). A controlled study of imargery rehearsal for chronic nightmares in sexual assault survirors with PTSD: A preliminary report. Journal of Traumatic Stress, 13(4), 589–609.

    Article  PubMed  Google Scholar 

  • Krakow, B., Johnston, L., Melendrez, D., Hollifield, M., Warner, T., Chavez-Kennedy, D., et al. (2001). An open-label trial of evidence-based cognitive behavior therapy for nightmares and insomnia in crime victims with PTSD. American Journal of Psychiatry, 158(12), 2043–2047.

    Article  PubMed  Google Scholar 

  • Krakow, B., Kellner, R., Pathak, D., & Lambert, L. (1995). Imagery rehearsal treatment for chronic nightmares. Behaviour Research and Therapy, 33(7), 837–843.

    Article  PubMed  Google Scholar 

  • Krakow, B., Sandoval, D., Schrader, R., Keuhne, B., McBride, L., Yau, C., et al. (2001). Treatment of chronic nightmares in adjudicated adolescent girls in a residential facility. Journal of Adolescent Health, 29, 94–100.

    Article  PubMed  Google Scholar 

  • Krakow, B., Schrader, R., Tandberg, D., Hollifield, M., Koss, M., & Yau, C. (2002). Nightmare frequency in sexual assault survivors with PTSD. Journal of Anxiety Disorders, 16, 175–190.

    Article  PubMed  Google Scholar 

  • Krakow, B., Tandberg, D., Scriggins, L., & Barey, M. (1995). A controlled comparison of self-rated sleep complaints in aute and chronic nightmare sufferers. Journal of Nervous and Mental Disease, 183, 623–627.

    Article  PubMed  Google Scholar 

  • Krakow, B., & Zadra, A. (2006). Clinical management of chronic nightmares: Imagery rehearsal therapy. Behavioral Sleep Medicine, 4(1), 45–70.

    Article  PubMed  Google Scholar 

  • Kribbs, N., Pack, A., Kline, L., Smith, P., Schwartz, A., & Schubert, N. (1993). Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. American Review of Respiratory Disease, 147, 887–895.

    PubMed  Google Scholar 

  • Lansky, M. (1995). Post truamatic nightmares: Psycho-dynamic explorations. Hillsdale, NJ: The Analytic Press.

    Google Scholar 

  • Levin, R. (1998). Nightmares and schizotypy. Psychiatry and Clinical Neurosciences, 61, 206–216.

    Google Scholar 

  • Lichstein, K. L. (1988). Clinical relaxation strategies. Hoboken, NJ: John Wiley and Sons Ltd.

    Google Scholar 

  • Littner, M., Hirshkowitz, M., Kramer, M., Kapen, S., Anderson, W., & Bailey, D. (2003). Practice parameters for using polysomnography to evaluate insomnia: An update. Sleep, 26(6), 754–760.

    PubMed  Google Scholar 

  • Mack, J. (1974). Nightmares and human conflict. Boston: Houghton Mifflin.

    Google Scholar 

  • Marks, I. (1978). Rehearsal relief of a nightmare. British Journal of Psychiatry, 135, 461–465.

    Article  Google Scholar 

  • Means, M. (2002). Mind over matter: Optimizing CPAP compliance. Advance for Managers of Respiratory Care, 11, 10–13.

    Google Scholar 

  • Means, M., & Edinger, J. (2007). Graded exposure therapy for addressing claustrophobic reactions to continuous positive airway pressure: A case series report. Behavioral Sleep Medicine, 5, 105–116.

    PubMed  Google Scholar 

  • Mellman, T. A., & Uhde, T. W. (1990). Patients with frequent sleep panic: Clinical findings and response to medication treatment. Journal of Clinical Psychiatry, 51(12), 513–516.

    Google Scholar 

  • Miller, W., & DiPilato, M. (1983). Treatment of nightmares via relaxation and desensitization: A controlled evaluation. Journal of Consulting and Clinical Psychology, 51, 870–877.

    Article  PubMed  Google Scholar 

  • Morin, C. M., Culbert, J. P., & Schwartz, S. M. (1994). Nonpharmacological interventions for insomnia: A meta-analysis of treatment efficacy. American Journal of Psychiatry, 151, 1172–1180.

    PubMed  Google Scholar 

  • Murtagh, D. R., & Greenwood, K. M. (1995). Identifying effective psychological treatments for insomnia: A meta-analysis. Journal of Consulting and Clinical Psychology, 63, 79–89.

    Article  PubMed  Google Scholar 

  • Neidhardt, E., Krakow, B., Kellner, R., & Pathak, D. (1992). The beneficial effects of one treatment session and recording of nightmares on chronic nightmare sufferers. Sleep, 15(5), 470–473.

    PubMed  Google Scholar 

  • Neylan, T., Marmar, C., Metzler, T., Weiss, D., Zatzick, D., & Delucchi, K. (1998). Sleep disturbances in the Vietnam generation: Findings from a nationally representative sample of male Vietnam veterans. American Journal of Psychiatry, 155, 929–933.

    PubMed  Google Scholar 

  • Nicassio, P., & Bootzin, R. R. (1974). A comparison of progressive relaxation and autogenic training as treatments for insomnia. Journal of Abnormal Psychology, 83, 253–260.

    Article  PubMed  Google Scholar 

  • Nielsen, T., & Zadra, A. (2005). Nightmares and other common dream disturbances. In M. Kryger, T. Roth, & W. Dement (Eds.), Principles and practice of sleep medicine (4th ed.). Philadelphia: Elsevier Saunders.

    Google Scholar 

  • Norton, P., & Price, E. (2007). A meta-analytic review of adult cognitive-behavioral treatment outcome across the anxiety disorders. Journal of Nervous and Mental Disease, 195(6), 521–531.

    Article  PubMed  Google Scholar 

  • Nowell, P. D., Mazumdar, S., Buysse, D. J., Dew, M. A., Reynolds, C. F. I., & Kupfer, D. J. (1997). Benzodiazepines and zolpidem for chronic insomnia: A meta-analysis of treatment efficacy. Journal of the American Medical Association, 278, 2170–2177.

    Article  PubMed  Google Scholar 

  • Partinen, M. (1994). Epidemiology of sleep disorders. In M. Kryger, T. Roth, & W. Dement (Eds.), Principles and practice of sleep medicine (2nd ed.). Philadelphia: WB Saunders.

    Google Scholar 

  • Rains, J. C. (1995). Treatment of obstructive sleep apnea in pediatric patients: Behavioral intervention for compliance with nasal continuous positive airway pressure. Clinical Pediatrics, 34, 535–541.

    Article  PubMed  Google Scholar 

  • Rauscher, H., Popp, W., Wanke, T., & Zwick, H. (1991). Acceptance of CPAP therapy for sleep apnea. Chest, 100, 1019–1023.

    Article  PubMed  Google Scholar 

  • Rolfe, I., Olson, L., & Saunders, N. (1991). Long-term aceptance of continuous positive airway pressure in obstructive sleep apnea. American Review of Respiratory Disease, 144, 1130–1133.

    PubMed  Google Scholar 

  • Roy-Byrne, P. P., Uhde, T. W., & Post, R. M. (1986). Effects of one night’s sleep deprivation on mood and behavior in panic disorder: Patients with panic disorder compared with depressed patients and normal controls. Arch Gen Psychiatry, 43(9), 895–899.

    PubMed  Google Scholar 

  • Rybarczyk, B., Stepanski, E., Fogg, L., Lopez, M., Barry, P., & Davis, A. (2005). A placebo-controlled test of Cognitive-Behavioral Therapy for comorbid insomnia in older adults. Journal of Consulting and Clinical Psychology, 73(6), 1164–1174.

    Article  PubMed  Google Scholar 

  • Sanders, M., Gruendl, C., & Rogers, R. (1986). Patient compliance with nasal CPAP therapy for sleep apnea. Chest, 90, 331–333.

    Google Scholar 

  • Schreuder, B., van Egmond, M., Kleijn, W., & Visser, A. (1998). Daily reports of posttraumatic nightmares and anxiety dreams in Dutch war victims. Journal of Anxiety Disorders, 12, 511–524.

    Article  PubMed  Google Scholar 

  • Schultz, J. H., & Luthe, W. (1959). Augenic training. New York: Grune & Stratton.

    Google Scholar 

  • Siev, J., & Chambless, D. (2007). Specificity of treatment effects: Cognitive therapy and relaxation for generalized anxiety and panic disorders. Journal of Consulting and Clinicial Psychology, 75(4), 513–522.

    Article  Google Scholar 

  • Smith, J. (1990). Cognitive-behavioral relaxation training: A new system of strategies for treatment and assessment. New York: Springer Publishing Company.

    Google Scholar 

  • Stetter, F., & Kupper, S. (2002). Autogenic training: A meta-analysis of clinical outcome studies. Applied Psychophysiology and Biofeedback, 27(1), 45–98.

    Article  PubMed  Google Scholar 

  • Zadra, A., & Dondri, D. (2000). Nightmares and bad dreams: Their prevalence and relationship to well-being. Journal of Abnormal Psychology, 109, 273–281.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, Ryerson University, Toronto, ON, Canada

    Colleen E. Carney

  2. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA

    Jack D. Edinger

Authors
  1. Colleen E. Carney
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jack D. Edinger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Colleen E. Carney .

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Carney, C.E., Edinger, J.D. (2010). Other Issues in Managing the Sleep of Those with Anxiety. In: Insomnia and Anxiety. Series in Anxiety and Related Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1434-7_9

Download citation

Publish with us

Policies and ethics

Search

Navigation