Editing Paradoxical intention (section)

=== For insomnia ===
Paradoxical intention has been shown as an effective therapy in the treatment of [[chronic insomnia]].<ref>CHESSON, A. L., ANDERSON, W. M., LITTNER, M., DAVILA, D., & HARTSE, K. (1999). Practice parameters for the non-pharmacologic treatment of chronic insomnia. Sleep, 22, 1128–1133.</ref> It attempts to eradicate the anxiety associated with the inability to sleep by instructing patients to do the opposite and attempt to stay awake. By asking patients to keep their eyes open, while lying comfortably in a dark room without sleeping, they are taught to understand the non-disastrous implications of staying awake and thus, the anxiety associated with it diminishes.<ref name=":1b">Jansson-Fröjmark, Markus, Sven Alfonsson, Benjamin Bohman, Alexander Rozental, and Annika Norell-Clarke. "Paradoxical Intention for Insomnia: A Systematic Review and Meta-analysis." Journal of Sleep Research (2021): E13464. Web.</ref><ref name=":2b">Broomfield, N., & Espie, C. (2003). Initial Insomnia And Paradoxical Intention: An Experimental Investigation Of Putative Mechanisms Using Subjective And Actigraphic Measurement Of Sleep. Behavioural and Cognitive Psychotherapy, 31(3), 313-324.</ref> Thereby in this manner, by eliminating voluntary sleep effort, paradoxical intention minimises sleep performance anxiety, promoting rapid sleep onset.<ref name=":3">{{Cite journal|last1=Ascher|first1=L. Michael|last2=Turner|first2=Ralph M.|date=1979-01-01|title=Paradoxical intention and insomnia: an experimental investigation|url=https://dx.doi.org/10.1016/0005-7967%2879%2990015-9|journal=Behaviour Research and Therapy|language=en|volume=17|issue=4|pages=408–411|doi=10.1016/0005-7967(79)90015-9|pmid=486046 |issn=0005-7967|url-access=subscription}}</ref> Similarly, it is also suggested that by diverting attention from sleep performance, it allows for cognitive de-arousal leading to relaxation and sleep.<ref name=":2b" />

A study investigating the effects of paradoxical intention on sleep effort, sleep anxiety and objective and subjective sleep showed that relative to control conditions, participants allocated to PI displayed noteworthy reductions in sleep effort and sleep performance anxiety. It has also been found that subjectively measured sleep onset latency [SOL] (time taken to fall asleep) is significantly lower in the PI conditions, with SOL change amongst PI participants being strongly associated with sleep effort change.<ref name=":0" /> This shows that sleep effort and sleep anxiety are integral mechanisms overridden by PI to achieve normal sleep functions.<ref name=":2" /> A 1984 study analysing cases of paradoxical intention as a treatment showed that PI rapidly reduced SOLs and was also successful at maintaining sleep onset and maximising total sleep time.<ref name=":4">{{Cite journal|last1=Espie|first1=Colin A.|last2=Lindsay|first2=William R.|date=1985-01-01|title=Paradoxical intention in the treatment of chronic insomnia: six case studies illustrating variability in therapeutic response|url=https://dx.doi.org/10.1016/0005-7967%2885%2990070-1|journal=Behaviour Research and Therapy|language=en|volume=23|issue=6|pages=703–709|doi=10.1016/0005-7967(85)90070-1|pmid=3907617 |issn=0005-7967|url-access=subscription}}</ref>

A 2021 meta-analysis conducted a systematic review of randomised control trials and experimental studies comparing PI for insomnia to passive and active comparators. Results showed that relative to passive comparators, PI showed radical improvements in several key insomnia symptoms with moderate improvements as compared to active comparators.<ref name=":1" /> It also promoted decreased sleep-related performance anxiety. Additionally, a 2018 meta-analysis contrasted cognitive and behavioural interventions with passive comparators and when compared to recent relations between PI and passive comparators, it is found that the effects of PI on SOL are larger.<ref>{{Cite journal|last1=van Straten|first1=Annemieke|last2=van der Zweerde|first2=Tanja|last3=Kleiboer|first3=Annet|last4=Cuijpers|first4=Pim|last5=Morin|first5=Charles M.|last6=Lancee|first6=Jaap|date=2018-04-01|title=Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis|url=https://www.sciencedirect.com/science/article/pii/S1087079217300345|journal=Sleep Medicine Reviews|language=en|volume=38|pages=3–16|doi=10.1016/j.smrv.2017.02.001|pmid=28392168 |hdl=1871.1/e4883309-0042-4b67-9d47-f262429db18a |s2cid=3359815 |issn=1087-0792|hdl-access=free}}</ref>