"Insomnia & CBT-I Workshop"
Presented By Don Prosner, PhD, CBSM, DBSM

APRIL 18, 2024 | 8:00 AM - 5:00 PM
Providence Willamette Falls Community Conference Center

OPA Member - $250        Non-Member - $350

REGISTER HERE

OPA will be hosting an additional CE workshop presented by Don Prosner, PhD, CBSM, DBSM the day before the 2024 Annual Conference begins. To register for this workshop, you will use the "2024 OPA Annual Conference | Attendee Registration" form. Once you have completed the 2024 Annual Conference section, it will bring you to the Thursday Workshop registration. Select whether you will be attending in-person or virtually and the workshop fee will be added to your registration submission.

 

Don Prosner, PhD, CBSM, DBSM

Dr. Donn Posner is the Founder and President of Sleepwell Consultants and has been consulting to organizations and individuals on a wide variety of sleep health issues including insomnia, circadian dysrhythmia, CPAP adherence, and parasomnias. He continues to operate a small clinical practice in Behavioral Sleep Medicine and is a licensed psychologist in California, Massachusetts, New Hampshire, Pennsylvania, and Rhode Island. He is also currently an Adjunct Clinical Associate Professor in the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine and a consulting psychologist, for the Palo Alto VA. He is working on a number of grants including one on exploring the effects of CBT-I in veterans with Mild Traumatic Brain Injury, and one on the effects of CBT-I dose on Cancer Related Fatigue (CRF) in breast cancer survivors.

Prior to this he spent 25 years serving as the Director of Behavioral Sleep Medicine for the Sleep Disorders Center of Lifespan Hospitals, and was a Clinical Associate Professor in the Department of Psychiatry and Human Behavior at the Warren Alpert School of Medicine at Brown University. Dr. Posner is a member of the American Academy of Sleep Medicine and is one of the first Certified Behavioral Sleep Medicine specialists recognized by that group. He is also a founding member of the Society of Behavioral Sleep Medicine and he has also now achieved the status of Diplomate with the Board of Behavioral Sleep Medicine (BBSM).

Workshop Description
This presentation will discuss how Insomnia Disorder is widely recognized to be the most common sleep problem and is also a leading complaint in primary care settings. The National Institutes of Health estimates that about 30% of the adult population has complaints about sleep and that number increases several fold in Behavioral Health, VA, and elderly populations.

The consequences and morbidity associated with chronic insomnia can be substantial across several domains including increased risk of psychiatric and medical disorders. Chief among the former would be anxiety and affective disorders. Among the latter, would be hypertension, cardio vascular disorders, and obesity , not to mention increased health care utilization, impaired quality of life, increased risk of falls and hip fractures, , and ultimately worse outcomes for all co-morbid disorders.

Cognitive Behavioral Therapy (CBT-I) is now recommended as the first line of treatment for chronic insomnia. CBT-I is a short-term intervention where up to 80% of subjects exhibit a significant treatment response and nearly 40% recover good sleep (remit).

The presentation will go on to show that unfortunately traditional wisdom often still describes insomnia a symptom of other disorders and therefore not worthy of targeted treatment. This is because the clinical assumption is that the insomnia will remit so long as the precipitating disorder has been addressed. The problem is over 30 years of evidence now suggest that if left untreated insomnia… 

  1. tends not to remit with treatment for other disorders (e.g., successful treat of anxiety and depression often doesn’t result in the resolution of the comorbid insomnia);

  2. remains a risk factor for new onset and/or recurrence of multiple psychiatric and/or medical disorders (e.g., insomnia confers 2-4x the risk for new onset or recurrence of depression… and increasing severity of insomnia may be a prodromal symptom of recurrence);

  3. when untreated, is associated with substantially reduced quality of life.

In addition, when insomnia is treated with CBT-I, not only can the insomnia improve, but it may confer positive effects on the disorders that occur co-morbidly including anxiety and depression. Therefore, comorbid insomnia warrants targeted treatment concomitant with the treatment of the other disorders. Further, cognitive-behavioral treatments for insomnia have been shown to be of equal effectiveness in the short term when compared to sedative hypnotic medication, and to outperform hypnotics in the long term.

The presentation will go on to discuss the behavioral model that explains how chronic insomnia evolves from acute insomnia, and why it can be successfully treated even in the context of other comorbidities. The presentation will conclude with tips on what non-sleep clinicians can do for their patients with acute insomnia, and how best to refer patients with more chronic and complicated cases for more depth treatment is required.

Workshop Learning Objectives

  1. Define the basics of sleep nomenclature including sleep period, phase, continuity, and architecture.

  2. Define and distinguish acute insomnia from Insomnia Disorder and discuss the importance of treating the chronic form as a specifically targeted co-morbidity.

  3. Cite the evidence for the efficacy of CBT-I for both primary and co-morbid insomnia disorder.

  4. Explain the Spielman model of insomnia and basics of sleep regulation, and demonstrate how to utilize these concepts in the deployment of CBT-I

  5. Explain how to obtain useable patient sleep diary data, and how to analyze the data for use in the course of CBT-I treatment

  6. Apply the techniques of Stimulus Control and Sleep Restriction therapy to the treatment of chronic Insomnia

  7. Apply the techniques of sleep hygiene education and cognitive therapeutic strategies to the treatment of chronic insomnia

  8. Apply a decision-making algorithm to case conceptualization.

  9. Explain the steps necessary to aide in good relapse prevention.