Insomnia: Have You Tried Cognitive Behavioral Therapy (CBT-I)?

According to a 2018 study, around 1 in 4 Americans experience insomnia[1] each year. The common sleep disorder[2] is marked by difficulties falling asleep or remaining asleep, resulting in people getting less sleep than recommended[3]. Although around 75% of insomnia cases are temporary, about 25% of sufferers develop chronic sleeping conditions.

In the short term, a lack of quality sleep can impact physical[4] and mental[5] well-being and affect a person's mood, memory[6], energy levels and, ultimately, quality of life. In the longer term, disordered sleep can lead to a wide range of serious health problems[7]. Indeed, scientists have linked poor-quality sleep with shorter lifespans[8].

People who've tried commonly suggested insomnia remedies[9] — such as adjusting eating habits[10], maintaining a sleep schedule, avoiding daytime naps, doing regular exercise and using essential oils[11] — and are still experiencing sleepless nights may feel frustrated … and tired! This article explores another possible solution: cognitive behavioral therapy for insomnia (CBT-I).

Overview of Cognitive Behavioral Therapy for Insomnia

Cognitive behavioral therapy[12] (CBT) is a psychological therapy that can help individuals overcome wide-ranging issues. However, cognitive behavioral therapy for insomnia[13] (CBT-I) specifically targets sleep problems and can help up to 80%[14] of people resolve their sleep challenges. Professional therapists tailor their approach using diverse strategies, relaxation techniques and sleep education. Many clients only need five or six sessions to benefit from improved sleep. Occasionally, people see an improvement after just two sessions.

How CBT-I Works

Cognitive behavioral therapy for insomnia addresses three key elements that create chronic insomnia:

• Worry surrounding sleep
• Conditioned arousal
• Ineffective habits

While focusing on these main factors, therapists lead insomniacs through various behavioral changes. People gain the knowledge and tools to overcome any challenges that stand in the way of implementing changes in their sleep activities and habits. As these changes take place, individuals experience better quality sleep. CBT-I also equips them with the techniques to prevent future sleepless nights from becoming a larger, ongoing issue.

Therapists often incorporate up to five common procedures:

• Biological clock[15] – Therapists may use techniques to adjust an individual's natural body clock, also known as a circadian rhythm[16].
• Foods and substances[17] – Through education and behavior modification, people avoid common sleep-evading mistakes when it comes to eating, consuming caffeine, drinking alcohol[18] and using other substances.
• Sleep restriction[19] – This step aims to gradually increase the time spent sleeping by initially limiting time in bed.
• Stimulus control[20] – This process seeks to reinforce the bed as a sleep prompt while minimizing the association with wakefulness. Techniques include maintaining sleep schedules, reducing naps and getting out of bed when an individual can't sleep.
• Arousal[21] – Diverse relaxation methods and attitude changes — such as avoiding clock watching, establishing a pre-bedtime wind-down routine and creating a clean[22] and pleasant sleep environment — can aid sleep.

CBT-I Resources

Individuals can obtain further support related to CBT-I from various sources, including their physician, self-help guides[23] and the CBT-I app[24].

If you're experiencing long-term insomnia, try cognitive behavioral therapy for insomnia for better sleep and better health.

Resources

1. Penn Medicine News – 1 in 4 Americans Develop Insomnia Each Year
2. Cleveland Clinic – Sleep Disorders
3. WebMD – How Much Sleep Do I Need?
4. Psychology Today – Sleep and Physical Health
5. Mental Health Foundation – Sleep Matters: The Impact of Sleep on Health and Wellbeing
6. WebMD – Sleep Deprivation and Memory Loss
7. National Heart, Lung, and Blood Institute – What Are Sleep Deprivation and Deficiency?
8. SoClean – New Research: Sleep Well to Live Longer
9. Healthline – 8 Home Remedies for Insomnia
10. SoClean – How Bad Is It to Eat Before Bed?
11. VeryWell Health – Essential Oils That Can Help You Sleep Better
12. Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder – What is Cognitive Behavioral Therapy?
13. Stanford Medicine Health Care – Cognitive Behavioral Therapy for Insomnia
14. National Library of Medicine – Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis
15. Stanford Medicine Health Care – Taking the Biological Clock into Account
16. National Institute of General Medical Sciences – Circadian Rhythms
17. Stanford Medicine Health Care – Foods and substances
18. Piedmont Healthcare – How does alcohol affect your sleep?
19. Stanford Medicine Health Care – Sleep Restriction and CBTI
20. Stanford Medicine Health Care – Stimulus Control and CBTI
21. Stanford Medicine Health Care – Sleep-Interfering Arousal/Activation
22. SoClean – A Clean Bedroom for Better Sleep
23. NHS Inform – Sleep problems and insomnia self-help guide
24. U.S. Department of Veterans Affairs – PTSD: National Center for PTSD