What is Cognitive Behavioral Therapy - Insomnia?

Are you experiencing difficulty falling asleep or staying asleep?

Do you have unhealthy sleeping habits?

Are you tossing and turning at night?

Are these symptoms impacting your daily functioning?

If so, you may have a sleep disorder. 

The good news is that there is a highly effective, strictly behavioral treatment that can improve your sleeping ability: CBT-Insomnia.

Insomnia is a sleep disorder where people may have trouble falling asleep or staying asleep. It can vary from short-term to long-term. Insomnia is the most prevalent sleep disorder, with 30% of adults reporting symptoms consistent with insomnia.

Sleep is important! Adults require 7+ hours of sleep to function properly. People with poor sleeping habits can experience memory issues, mood changes, a weakened immune system, high blood pressure, weight gain, among many more issues. These health issues can also cause increased health costs and more days out of work (National Sleep Foundation, 2022). People with sleep difficulties also have a higher risk of not recovering from psychological disorders.

When a person’s sleep rhythm is off, their body has difficulty distinguishing when they’re supposed to be sleeping and when they’re supposed to be awake. CBT for Insomnia (CBT-I) is a form of therapy that aims to increase the body’s connection between sleep and bed, improve sleep hygiene, and establish healthy sleeping habits. CBT-I is a strictly behavioral treatment that has better and longer-lasting effects than medication for insomnia. There are 6 techniques involved in CBT-I.

Here are some of the intervention pieces of Cognitive Behavioral Therapy-Insomnia: 

Sleep diary

The first step to CBT-I is a sleep diary. This will help us understand what is happening with your sleep. Are you having difficulty falling asleep? Staying asleep? How long are you actually sleeping? When are you waking up? These are all questions and patterns that will be revealed in a sleep diary. 

Sleep restriction

The goal of sleep restriction is to consolidate sleep, so we are only in bed for the amount of time we are actually sleeping. We really want to make our bodies tired, so it is easier to fall asleep when you get into bed.

Stimulus control

Stimulus control requires us to get out of bed if we are not sleeping. We want the body to recognize that the bed is only for sleep, so we can’t be in bed if we are not sleeping. 

Arousal Reduction

Arousal reduction aims to increase relaxation and reduce worry around bedtime. We want a person to establish a buffer zone (a comfortable place outside the bedroom where the person can relax). Some people enjoy having slippers, a robe, lavender diffuser, or other things that make them feel comfortable and relaxed in their buffer zone. There should be no screens or bright light in this area! We may benefit from reading a book or engaging in other calming activities in this space.   

Sleep Hygiene

This piece addresses substance use, caffeine intake, food intake, and exercise. We want the body to move regularly for mealtimes, medication, and other elements. Having a rhythm throughout the day helps our body recognize when it’s time to eat and sleep.

Cognitive Restructuring

Lastly, we want to transform negative thoughts and beliefs around sleep into a more helpful way of thinking. Instead of saying, “Wow, I’m never going to fall asleep tonight,” we can say something like, “I’m awake right now, and when I get tired later, I will be able to fall asleep.”  

CBT-I treatment consists of around 6-8 sessions that are roughly 45-minutes long. According to the Sleep foundation (2022), 70-80% of clients experience improvements with their sleep when these interventions are used properly.  In working with me and putting effort into this type of treatment, you will look back at the progress you‘ve made over those 8 weeks, and be thankful that you took the time to improve your sleep!

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