Tossing, turning, punching the pillow. Hands on the clock tick inexorably onward, but sleep will not come; the mind refuses to shut down. Midnight, 1 a.m., 2 a.m. and later, and the alarm will go off at 6 for work. Stress at the job, anxiety at home, financial woes, relationship trouble. Another night falls victim. Another day at less than your best for lack of “a good night’s sleep.”
Sound familiar? Perhaps it doesn’t have to. Help may be as close as Mississippi State’s new sleep disorder specialty treatment clinic. The university’s Psychology Clinic is offering evidence-based cognitive behavioral assessment and interventions to individuals affected by sleep disorders such as insomnia, nightmares or even sleepwalking.
Clinic staff members are applied psychology/clinical psychology doctoral students Brittany Kinman of Gulfport and Katrina “Kat” Speed of Columbus, along with Christopher Drapeau of Starkville, a postdoctoral fellow in the university’s Sleep, Suicide and Aging Laboratory. Michael Nadorff, MSU assistant professor of psychology, oversees the clinic. Nadorff is a licensed psychologist on the Behavioral Sleep Medicine roster of practitioners in Mississippi.
Ann in Columbus views the new clinic as a potential lifeline. She prefers not to use her last name. Plagued by recurring insomnia due to a high-pressure job, her solution has been sleeping pills. She knows her long-term use, however, comes with problems of its own.
“We do behavioral treatments,” said Nadorff. “It’s important that there is a consensus paper that came out over the summer from the American College of Physicians that said the preferred treatment for insomnia is behavioral; it’s not using sleep medications.”
Indeed, a new clinic practice guideline published in May in Annals of Internal Medicine states that cognitive behavioral therapy for insomnia should be the first-time treatment for adults with chronic insomnia. It also notes that sleep medications can be associated with serious adverse effects.
No, not “normal”
Too often, people experiencing sleep disorders become resigned to them as inevitable, or “normal.”
“People don’t realize that it’s something that can be treated, and in a very cost-effective way,” said Speed.
Therapies at the clinic vary. They range from CBT-I — cognitive behavioral therapy for insomnia — to, in the case of nightmares, image rehearsal therapy.
“Part of image rehearsal therapy is identifying problematic areas or themes and helping you develop a better outcome for it, helping you learn how to change the outcome and practicing that,” Speed explained.
In cases of sleepwalking, behavioral therapies include identifying when incidences occur. Sleepwalking happens during deep, non-REM (rapid eye movement) sleep, Nadorff said, usually about the same time every night.
“We have people track when it happens, set an alarm for about a half hour before that time, and when the magic time comes, they’re not in a deep enough sleep to sleepwalk,” he explained.
Gathering data
A helpful tool in client assessment is an actigraph unit. Similar to a Fitbit worn on the wrist, the powerful monitor collects data about human rest and activity cycles.
“Worn 24 hours a day for a week, it measures movement and light,” explained Nadorff. Actigraphs will reveal how long the wearer has taken to fall asleep, how many times they woke up and much more.
Speed previously worked with Contact Helpline, a 24-hour crisis intervention hotline based in Columbus. She is especially attuned to potential connections between sleep disorders and depression or suicide in certain individuals.
“Research-wise, we’ve seen in studies that there is a connection between sleep and depression, connections between nightmares and suicide,” she said. Treating for insomnia and nightmares is especially important for those who have depression or are more likely to develop depression.
“It’s very treatable, and if we can target that it might prevent someone from having as many suicidal thoughts,” said Speed.
Kinman has worked in inpatient settings and seen firsthand how sleep problems can impact someone’s life.
“Treatment can be such a life changer in altering a patient’s trajectory, and working at the new clinic can help me learn more.”
While the clinic helps individuals with treatment and referrals, it also provides opportunities to train the psychology field’s next generation of professionals. For Speed, Kinman and Drapeau, that is an invaluable experience.
“If I decide to work in private practice, working at this new clinic will teach me how to get referrals and clients, as well as about interventions, so I can do them on my own,” Drapeau said. “Being able to make a big impact on a patient’s life is what makes coming to work exciting.”
Cost and contact
Per-session cost at the specialty clinic on the MSU campus ranges from $5 to $50 based on the client’s income. For more information, contact Nadorff at [email protected], or call 662-325-1222.
Editor’s note: Some information in this story was provided by the MSU Office of Public Affairs.
Jan Swoope is the Lifestyles Editor for The Commercial Dispatch.
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