By Nick Orr
Insights and takeaways from the early November conference for Sleep Professionals, put on by the Board of Registered Polysomnographic Technologists (BRPT) and the Society of Behavioral Sleep Medicine (SBSM)
In early November, I attended the 2022 Behavioral Sleep Medicine’s 4th Annual Scientific Conference and CCSH Advanced Course in Washington, D.C. The event was well-attended, insightful, and a great opportunity to network with many great thinkers in behavioral sleep medicine.
Before I jump into a few takeaways from this excellent event, I want to give a special shout-out to conference leaders Andrea Ramberg, MS, CCSH, RPSGT of the BRPT, and Kathryn Hansen, BS, CPC, CPMA, REEGT of the SBSM.
Insomnia, PTSD, and Nightmares
One of the more interesting presentations at the conference was on Imagery Rehearsal Therapy (IRT) and its application as a treatment of nightmare disorder. The topic was presented by Adrienne Stamper, MA, ATR-P, an Art Therapist at The National Intrepid Center of Excellence.
Per Stamper, Imagery Rehearsal Therapy + Art Therapy (IRT+AT) is an exploratory treatment for post-traumatic nightmares (PTN) and may be practiced by a licensed art therapist. IRT + AT builds upon the basic principles of IRT by incorporating an artistic depiction of the new, rescripted dream to strengthen and reinforce the new dream.
While writing is the gold standard, other auditory and visual expressions can be valuable, as well. In fact, other types of memory transfer can be important ways to mentally address recurring nightmares. Per Stamper, painting and other visual art can be very therapeutic for patients, and she shared several examples.
“Anecdotally, the act of visualization involved in IRT can be difficult for some patients to master through writing alone and incorporating art therapy may help to instill the imagery and sensory content of the new dream,” Stamper shared.
One such story involves a gentleman whose family was tragically swept away by large waves during a brutal storm. Stamper referenced how he was able to reframe the experience through therapeutic painting. By manifesting themes and motifs of safety, including lifejackets and praying hands, the man subsequently experienced a complete cessation of nightmares and intrusive thoughts.
Per Stamper, “the exploratory efforts suggest that IRT+AT may be a viable approach to address the needs of patients with post-traumatic nightmares that are not adequately addressed with currently available treatments.”
Ultimately, there is no single solution to sleep challenges, but finding tricks – like journaling or painting – can be a great place to start for patients.
Novel Sleep Research Excites and Inspires
Outside of the presentations, I had several exhilarating conversations with postdoctoral fellows about novel research in behavioral sleep medicine. Topics included an interface that examined the relationship between sleep and cancer, and what we may be able to learn from that data. Another researcher was investigating specific chemical reactions during different periods of the night and for different sleep disorders.
While my conversations with these researchers were engrossing, and I’d like to share all their secrets with you, I want to be respectful of their work, so I’ll leave you with just those teasers.
Nevertheless, it was a fascinating opportunity to learn about the novel ways people are approaching sleep disorders. Clinical psychologists seem to address and explore sleep questions in a different way than I’ve seen from my relationships with advanced practitioners, RPSGTs, and medical doctors.
There are always new ways to approach sleep care, and the ideas were flowing fast and plentiful at this year’s conference.
Managing Sleep Apnea and Insomnia Effectively
Another of the more riveting sessions was presented by Earl Charles Crew, PhD, DBSM. Dr. Crew’s patient was a war veteran who hadn’t slept well in over 15 years. He had a sleep study, was diagnosed with OSA, but wasn’t using his CPAP. Furthermore, he had perpetual insomnia. In short, he had COMISA (or comorbid insomnia with sleep apnea).
Per Sweetman, et. al, COMISA is “a highly prevalent and debilitating disorder, which results in additive impairments to patients’ sleep, daytime functioning, and quality of life, and complex diagnostic and treatment decisions for clinicians.”
In a sense, COMISA is a bit of a chicken-and-egg situation. Is the insomnia causing the patient to avoid mask wearing? Or is the untreated OSA causing them to arouse regularly and fail to fall back asleep? And after thinking about those both, what is the best way to treat such a challenging patient?
For Dr. Crew, the answer to that question involved meeting the patient where he was: literally and figuratively. They started by addressing the patient’s anxieties around CPAP mask usage. From there, they were able to slowly work to find ways to improve the patient’s insomnia.
The patient may not ever have perfect sleep, but some peace during the night is still a life changer.
Platforms for Leveraging Cognitive Behavioral Therapy to Treat Insomnia
The final takeaway from the 2022 Behavioral Sleep Medicine conference was on the great number of solutions currently leveraging cognitive behavioral therapy to treat insomnia (CBT-I). Among the innovators were organizations Smart Swapping, Nocetem Health, and HALEO Virtual Sleep Clinic.
Smart Swapping’s aim is to modernize conventional weight and fitness programs, and bring sleep into the limelight as an integral part of an individual’s overall health. Their platform is simple for users, and can be supplemental to traditional materials and client journeys.
For both Noctem Health and the HALEO Virtual Sleep Clinic, the goal is to eliminate the hassles of traditional behavioral sleep treatments while also maintaining the quality and continuity of care for patients.
Noctem Health helps multiply provider capacity to treat patients with insomnia using their evidence-based digital solution. Similarly, HALEO delivers a solution to allow patients access to professional treatment for insomnia and poor sleep without setting foot in a clinic and taking time off work.
These new platforms provide optimism for the future of treating insomnia. And with that, I’m going to sign off from the behavioral sleep medicine conference for the year. It was a good one, and I can’t wait to get back next year!
To learn more about some recent 2022 sleep conferences, feel free to check out some other recent content from our team:
Another of my recaps: The ABCs of Respiratory Therapy and How RTs Impact Sleep Medicine