• Jesse Thornton

Cognitive Behavioral Therapy: Insomnia

Updated: Sep 16, 2021

We all know what it is like to get a poor night’s sleep. We become groggy, moody, and have difficulty concentrating at work. When insomnia becomes a pattern it can create a crisis in our lives. We search for solutions to get much needed relief. What’s more, chronic sleeplessness leads to increased health conditions including depression. Often we turn to pharmacy or natural forms of medication. In the short term, medications appear to solve the problem. However, sleeping pills make you feel groggy during the day and actually interfere with our natural sleep cycles. Plus, medicines actually lead to increased sleep problems after two-to-three weeks of use. So what is the solution? The answer in the medical community increasingly turns to Cognitive Behavioral Therapy for Insomnia (CBT-I), which has shown to be a highly effective treatment to improve sleep.

Different Types of Insomnia

First thing to note is that not all insomnia is the same. Secondary Insomnia results from chronic pain or medical conditions. Primary Insomnia results from stress, jet lag, diet, and other factors. Most people with primary insomnia have trouble falling asleep, referred to as sleep onset insomnia, or they have trouble remaining asleep, which is called sleep maintenance insomnia. Insomnia often develops into a pattern known as “conditioned” or “learned” insomnia. This leads to increased rumination about sleeping during the day and arousal during sleep times. When untreated, it is very persistent. However, with assistance, Cognitive Behavioral Therapy is a highly effective way to manage insomnia.

Cognitive Behavioral Therapy for Insomnia (CBT-I)

Cognitive Behavioral Therapy for Insomnia is a short-term treatment that examines a person’s life to determine the factors that cause their insomnia. Issues such as anxiety, alcohol, screens, or poor sleep practices may all exacerbate the problem. In our modern world, there are many stresses that lead to conditioned insomnia. Below are several steps involved in CBT-I that will help you begin to retake the rest you need:

1) Keep a sleep journal

It is important to journal your sleep patterns including sleep time activity such as time spent in a bed, time going to sleep, time falling asleep, wake times, etc. Also include daily activities such as caffeine and alcohol intake, time watching television, and stressful events or conversations. This helps develop awareness of factors may be influencing your sleep. Most people are surprised at how much their daily activities influence their sleep patterns.

2) Practice good sleep hygiene

Good sleep hygiene is very important to manage insomnia. These practices include limiting alcohol and caffeine use, limiting non-sleeping time in bed (including watching TV), and developing a wind-down routine.  Managing light and temperature are important ways to control our environment.  Remember, not too long ago we had little control over these factors. Fostering our conditions has an important effect on our ability to fall asleep.

3) Sleep Restriction

Sleep restriction is a tough part of Cognitive Behavioral Therapy for insomnia. When tired, most people lie in bed and attempt to fall asleep. With insomnia, however, lying in bed leads to anxious arousal, rumination, and longer periods of failure to sleep.  This only sets up a fear of our beds, making it harder to fall asleep.  Sleep restriction is a set time-frame when a person lays down and gets up. When restricting the amount of time spent in bed, our bodies learn there is only a window of time to fall asleep. After one or two weeks, we adjust to these parameters. Sleep restriction results in more easily falling asleep and getting better quality of sleep.

4) Mindfulness Meditation

Life is stressful. It is not uncommon to become anxious, especially when trying to wind down to sleep for the night. With insomnia, settling into bed often results in anxious arousal as well as wandering thoughts about the day. Mindfulness meditation is a scientifically researched tool to effectively manage anxiety. Practicing mindfulness on a daily or weekly basis helps manage unwanted anxiety and thoughts that perpetuate insomnia.

If you or a loved one experiences prolonged insomnia and want to learn more about ending the struggle, contact Foundations Family Counseling to meet with a provider who can get you onto a path of consistent restful sleep.  If you feel you may suffer from depression as a result of poor sleep, you may benefit from learning more about what depression is.  Here is more information on depression: Depression, What is Depression



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