Cognitive Behavioral Therapy for Insomnia (CBT-I)
CBT-I is a specific type of cognitive behavioral therapy (CBT) for the treatment of insomnia. CBT-I works by identifying and changing the thoughts and behaviors that make it hard for a person to sleep at night.
Why do people have insomnia?
Insomnia may arise as a primary disorder and in this case, may be due to:
stress or stressful thoughts can interfere with one’s ability to sleep
poor sleep habits or practices
not prioritizing sleep
a poor sleep environment
Insomnia may be associated with various mental health problems including:
Traumatic life events
Components of CBT-I
When it comes to treating insomnia, CBT-I has a huge tool box that includes:
Identifying automatic thoughts that keep you awake. You may think you can’t stop these thoughts from appearing in your mind, and that may be true, but by learning to identify and counter them, you can minimize the damage they do to your ability to sleep.
Sleep hygiene means making basic lifestyle changes that can make it easier to sleep. You might try getting more regular exercise or cut down on smoking, caffeine, and alcohol, or alter your consumption patterns so they don’t interfere with sleep. You will also work on developing a winding down routine.
Sleep restriction means spending less time in bed to sleep more. It may seem paradoxical, but if you regularly spend too much time awake in bed, you can train your body not to sleep when it’s in bed. By not going to bed until you’re tired enough to fall asleep right away, you can train your body to fall asleep quicker when you go to bed. Then you can gradually lengthen the time you stay in bed—and therefore sleep.
Relaxation training can be very useful for people who are kept awake or awakened by stress. Meditation, imagery training, yoga, and other approaches can be used.
Passive wakefulness is a great technique for people who try too hard to go to sleep and find that anxiety about not sleeping is keeping them awake.
Sleep environment changes can make a big difference in a person’s ability to sleep. A quiet, dark, cool, environment that is free of disruptive electronics can make a big difference in your ability to sleep.
Finally, strategies from other evidence-based psychotherapies such as ACT, DBT and mindfulness-based approaches may be used to address the anxiety that often occurs with insomnia
How many sessions will CBT-I take?
The duration of CBT-I depends on the exact nature of your sleep disturbance, but is often achieved in 5-12 sessions. If there are more complicated issues affecting sleep such as a major life change, health issues, or an underlying mental health issue such as an anxiety disorder, CBT-I will require more sessions.
