Monthly Archives: February 2019

Cognitive Behavioral Therapy for Insomnia

Insomnia, in simple terms, can be defined as not being able to sleep. The medical definition, according to the National Sleep Foundation, is “difficulty falling asleep or staying asleep, even with a person has the chance to do so.”

Insomnia is a major problem facing many Americans today. About one in four women show signs of insomnia, and one in seven adults suffer from long- term (chronic) insomnia. There are some who rely on natural sleep remedies such as a diffuser with calming scents to induce sleep, and others rely on prescription medications to help them fall asleep and stay asleep. And then there are some that try an alternative form of ‘therapy’ – Cognitive Behavioral Therapy for Insomnia or CBT-I for short.

CBT-I, according to the National Institute of Health, “is a safe and effective means of managing chronic insomnia and its effects.” The way CBT-I works is similar to seeing a therapist. You go in and speak with a clinician and go through a number of assessments. You will keep a sleep diary, it should track if/when you have trouble falling asleep; how many time you wake up throughout the night; and when you get into bed to actually go to sleep and when you wake up to begin your day, which you will reference through the sessions with the clinician. Essentially, you are retraining your brain on how and when to sleep.

The first step in CBT-I is known as Sleep Restriction Therapy. This occurs within the first six weeks of CBT-I. You will you utilize your sleep diary throughout this period discussing your results with your clinician. Based on the research that I found, one clinician told his patient not to go to sleep until midnight despite that patient having to wake up early everyday during the work week. The patient reported that she was getting less sleep than before she started CBT-I, however by the end of the sixth week she was finally able to fall asleep quickly and stay asleep throughout the night.

Other parts of the CBT-I process are known as Stimulus Control Instructions and Sleep Hygiene Education. “Stimulus Control Instructions are created by looking at the patient’s sleep habits and pinpointing different actions that may be prohibiting sleep,” says the National Sleep Foundation. The answer for this is quite simple – no eating or watching TV in the bedroom. Anything other then sleep should not take place in the bedroom. If you find yourself wide awake and unable to sleep, it is advised that you leave your bedroom – this will help train your mind and body. Sleep Hygiene Education involves learning about the do’s and do not’s of sleep like sleeping in cool, dark room is the most ideal thing to do, and avoid caffeine, alcohol or heavy meals near bedtime.

There is much more to CBT-I then what we have discussed today. It is a long process, but with some time and continued effort, I think the results will be very promising.