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Chronic insomnia: Finding an alternative intervention technique

A recent study investigated the efficacy of a cognitive behavioural intervention technique called PSAI in tackling chronic insomnia.

Chronic insomnia is a common sleep disorder linked to a number of other conditions such as cardiovascular and mental illnesses. Health care practitioners estimate that 30-35% of the general population experience some form of insomnia. It is believed that 9-11% may suffer from chronic insomnia, which has a very adverse effect on their mental, social, and professional lives A recent study published in the journal Complementary Therapies in Medicine, explored more efficient techniques to manage the symptoms of chronic insomnia.

The Pythagorean Self-Awareness Intervention

The study examined the effectiveness of a cognitive intervention termed “Pythagorean Self-Awareness Intervention” in patients with chronic insomnia.

PSAI, a form of cognitive behavioural therapy, was inspired by Pythagoras, who educated people about a philosophy that is timeless. It involves a series of daily physical and mental exercises, through a wholesome approach that clearly impacted trainees’ lives. Practising memory skills and introspection were two of the most important tools used as part of this approach, which also aided in self-mastery and self-knowledge.

For the study, the recommendation was to practice the intervention at a quiet place wherein individuals recalled every event in the day in the same time sequence it occurred.  The recall was facilitated using categories such as diet, sleep, physical exercise, and impersonal content. The individual was directed to stay detached and consider the actions carefully. Positive self-reinforcement,  which they called “rejoice” and negative self-reinforcement, which they called “reprimand”, were used in order to set specific goals for the next day.

This pilot study included 30 individuals and was an uncontrolled, experimental procedure. The patients were all diagnosed with chronic insomnia according to the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (5th edition). The recruitment of patients occurred at the Atkinson General Hospital over a period of a year. These patients were between 18-85 years of age and could read and write Greek.  People going through major or drastic life changes, who had other big physical or psychological illnesses, or those taking medication for a condition other than chronic insomnia were excluded from this study. The PSAI intervention was administered for eight and 16-week periods in nine weekly sessions.

Pilot study results support next steps towards a clinical trial

The feasibility data for this study clearly indicates that patients with chronic insomnia are responsive to non-pharmaceutical interventions to tackle insomnia. An important consideration is that patients were willing to comply with the treatment, given the lack of side effects and also the lack of dropouts from the study, however, a larger clinical study will provide more concrete conclusions. The lack of a control group to compare with the PSAI group means that the retention of acquired skills cannot be commented upon in this study.

Written by Sonia Leslie Fernandez, Medical News Writer

Reference: Tsoli, S., Vasdekis, S., Tigani, X., Artemiadis, A., Chrousos, G., & Darviri, C. (2018). A novel cognitive behavioral treatment for patients with chronic insomnia: A pilot experimental study. Complementary Therapies in Medicine37, 61-63.



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