Thérapie comportementale et cognitive de l'insomnie

Up to 15% of the general population complains of psychophysiological insomnia. For many years, pharmacotherapy has been the only treatment available. However nowadays, cognitive behavioral therapies for insomnia (CBTI) have proven to be fairly efficient. The present review recalls the historical evolution of CBTI since the 1950s. It presents the definition of psychophysiological insomnia, the assessment of the differential diagnosis and the major comorbidities (anxiety, depression) as well as the most frequent personality traits associated with insomnia. The CBTI intervention, first of all, involves the sleep history and the baseline assessment of the complaint through the sleep diary. The behavioral component of the therapy includes information on sleep, sleep hygiene advice, relaxation techniques and sleep scheduling through stimulus control and sleep restriction. The cognitive stage involves a functional analysis likely to identify the maintenance factors of insomnia, as well as cognitive shaping, applied to change beliefs and attitudes about sleep.