An Integrative Model for the Analysis and Treatment of Insomnia

The present paper describes an integrative cognitive-behavioural model for the analysis and treatment of insomnia. According to the theoretical model, insomnia is the result of an interaction between sleep-interfering processes (e.g. various kinds of arousal, and processes whereby various stimuli, behaviours and cognitive activities lead to arousal) and sleep-interpreting processes (sleep-related beliefs, attributions, attitudes, etc.). It is argued that insomnia involves various combinations of such processes, and that treatment should be based on a cognitive-behavioural analysis of how these processes combine in each particular case of insomnia. The treatment model focuses both on a reduction of sleep-interfering arousal processes (e.g. by replacing willful goal-directed control strategies with skills of mindful observation and acceptance) and on a modification of sleep-interpreting processes (by means of behavioural experiments and psychoeducative interventions).