Behavioral self-management in treating sleep-maintenance insomnia.

Three controlled case studies are presented to demonstrate the application of behavioral self-management to two subtypes of sleep-maintenance insomnia. Patient 1 suffered from brief but frequent arousals to wakefulness and to NREM Stage 1 sleep. Patient 2 suffered from brief but frequent arousals and extended minutes awake after sleep onset. Patient 3 suffered from an extended latency to sleep onset and also extended minutes awake after sleep onset. The self-management treatment program was designed to teach these patients skills for identifying and modifying environmental, behavioral, physiological, and cognitive conditions related to poor sleep. Results are documented using home and laboratory all-night sleep recordings during treatment and at 3 and 12 months following the end of treatment.