Living with insomnia can take a tremendous toll on your health. Sleep deprivation can cause a number of health problems including high blood pressure, weight gain, diabetes, low immunity levels, high levels of cortisol, depression, and a low sex drive. Even so, insomnia remains one of the common sleep disorders in America, affecting nearly 70 million people. Most people with insomnia attempt to solve their poor slumber with over-the-counter medications or prescription sleeping pills. But research shows that insomnia can be treated without pills and medicinal drugs. Cognitive behavioral therapy for insomnia (CBTI) is a scientifically proven, highly effective way to treat insomnia and combat the frustrating symptoms associated with the condition.
Understanding Cognitive Behavioral Therapy for Insomnia
Cognitive behavioral therapy for insomnia is a 4-6 session treatment program that helps people who have difficulty falling and staying asleep. Essentially, CBTI teaches people struggling with insomnia a set of skills they can use if and when they’re unable to fall or stay asleep. But CBTI is more than basic sleep advice. The program, which is typically administered by psychologists, psychiatrists, and other doctors, incorporates several scientifically proven components which include:
- Cognitive restructuring, which attempts to change inaccurate and unhelpful thoughts about sleep.
- Behavioral intervention, which focuses on developing healthy sleep habits. Some of the most common behavioral interventions used in CBTI include relaxation training, stimulus control, and sleep restriction techniques.
- Psychoeducational learning, which teaches patients about the connection between thoughts, feelings, behaviors, and sleep.
How Does CBT Help Treat Insomnia?
Cognitive behavioral therapy helps treat insomnia by exploring the connection between how individuals think, act, and sleep. During treatment, a trained CBTI provider helps individuals identify thoughts, feelings, and behaviors that may lead to insomnia. Individuals are then asked to examine their thoughts and feelings about sleep while therapists examine their behavior patterns to see if they promote healthy sleep or encourage insomnia. From there, CBTI therapists use cognitive, behavioral, and psychoeducational interventions to reframe any misconceptions about sleep and change habits that disrupt sleep.
Some of the most common techniques used in CBTI include:
Stimulus control focuses on helping individuals have a positive response when they get in bed at night. Most people with insomnia dread their bedroom and associate the bed with wakefulness and frustration. They may also associate the bed and bedroom with habits that make sleeping difficult like eating, watching television, and using their cell phone or computer. Stimulus control works to change these associations by encouraging individuals to use the bed only for sex and sleep, reclaiming the bedroom as a place for rest. Stimulus control also teaches people to only go to bed when they feel very sleepy. If they’re not sleepy within 10 minutes, CBTI therapists tell individuals to get out of bed, do something relaxing, and return to bed when they feel tired. In time, this method teaches individuals to fall asleep shortly after getting in bed, decreasing their frustration with sleep and producing a more relaxing and restful night.
Cognitive Restructuring Therapy
Cognitive restructuring therapy identifies thoughts, attitudes, and beliefs that interfere with individuals’ sleeping habits. Prior experiences of insomnia may lead patients to have concerns about falling asleep. Cognitive restructuring attempts to break this cycle by identifying, challenging, and altering disturbing thoughts. This technique also teaches individuals ways they can overcome these negative thoughts and feelings. One common strategy is to set up a “worry time” in the afternoon or early evening. This is a specific time of day that allows individuals to review their day and “write out” their worries so they’re free to relax at bedtime. Guided imagery also helps individuals keep their minds off of worries, allowing the mind to settle down and stop racing.
Relaxation therapy teaches individuals how to relax their mind and body, reducing the anxiety and tension that keeps them up at night. Common techniques and lifestyle practices used in CBTI relaxation therapy include:
- Progressive muscle relaxation, which involves tensing and relaxing different muscle groups. These techniques are frequently combined with breathing exercises and visualization.
- Autogenic training, which teaches individuals to notice different sensations (i.e. heaviness, warmth, coldness) on various parts of the body.
- Biofeedback, which monitors brain waves, heart rate, breathing, and body temperature. Using information from biofeedback can help individuals learn to have more control over their bodily functions, increasing their ability to relax and promoting better sleeping habits.
- Meditation, yoga, and tai chi, which teaches individuals to focus their attention and reduce stress and anxiety.
Sleep-restriction therapy sets limits on the amount of time you spend in bed each night. Most people with insomnia spend a lot of time lying in bed awake. Sleep restriction limits the time spent in bed to help reestablish a consistent sleeping pattern. At first, the time limit is equal to the amount of sleep that individuals tend to get on a nightly basis. For example, if you sleep for 5 hours a night, but spend 7 hours in bed, your total time in bed will be restricted to 5 hours. In the beginning, the loss of sleep may make individuals even more tired. Eventually, the restriction will help you fall asleep faster and wake up fewer times a night, creating a stable sleeping pattern. Ultimately, the goal is for individuals to reach the point where they get the amount of sleep they need without reducing the quality of their sleep.
Sleep Hygiene Education
Sleep hygiene education helps individuals correct things they do on a regular basis that may disturb their ability to sleep well. Common disturbances to sleep hygiene include drinking caffeine in the evening, taking long naps in the afternoon, and spending time on devices that emit large amounts of blue light, such as phones, tablets, and computer screens. Sleep hygiene education also helps individuals develop healthy sleep habits, such as following their biological circadian rhythm, eating a balanced diet, exercising, and limiting stressors.
Holistic Treatment for Holistic Health
Poor sleep can have a number of negative effects on your overall health. Insomnia can even trigger substance abuse and mental health challenges. Luckily, the brain is neuroplastic and can change for the better when you adopt healthier habits and lifestyle practices. That’s why at StoneRidge Centers, we incorporate brain science, and the “brain diet” into our clinical support treatment programs.
Let us help you work toward physical, mental, and emotional health. Contact us today if you’re interested in learning more about our innovative and holistic approach to treatment.
Innovative, Evidence-Based Therapies
Because mental health and addiction concerns are so often interconnected, we utilize research-based approaches with evidence-based outcomes that promote overall healing and recovery.