CBT for Insomnia

Cognitive behavioral therapy (CBT) for insomnia treatment is a brief, practical form of therapy that focuses on changing how a person thinks about and reacts to specific situations as a way to increase restful sleep. Although it's relatively straightforward in principle, CBT must be done well to work well. It takes time and effort to help with sleepless nights. Unfortunately, CBT-trained psychologists can be hard to find, so primary care doctors are more likely to prescribe Ambien than refer a patient to a clinical psychologist with specialized training in sleep disorders. 

In CBT for Insomnia, patients keep a sleep journal for several weeks, identify habits interfering with getting to sleep and staying asleep, and learn behavioral skills to increase their amount of restful sleep. The therapist prescribes very specific behaviors to do to change unhelpful habits, and adjusts the weekly plan based on data collected from sleep journals. The interventions usually involve some combination of sleep hygiene, stress reduction, and cognitive restructuring strategies. 

The treatment typically takes six meetings with a therapist, but clinical research experiments have shown that it can work in as few as two sessions for some individuals. Sometimes psychological problems such as generalized anxiety or depression can cause sleep problems. When this is the case, treatment focuses on resolving the anxiety or depression, which can take as long as 16 sessions for some individuals. 

Usually, sleep problems result from several sources, all of which can be targeted in insomnia therapy. These are poor sleep habits, intrusive thoughts, and interference from emotions.

Poor Sleep Hygiene

Sleep hygiene refers to healthy sleeping behaviors. Over time, many adults develop habits that can interfere with restful sleep. As these habits accumulate, and are compounded by increased stress and worry, poor sleep hygiene can have a detrimental effect on your ability to get consistent restful sleep. CBT for insomnia identifies problematic sleep hygiene deficits, and targets them directly with a comprehensive behavior modification program. By developing new, healthier sleep habits, you are able to quickly return to a restful sleep routine. 

Intrusive Thoughts

Intrusive thoughts refers to the verbal chatter that goes on long after your head hits the pillow. We are constantly thinking throughout the day, and if you are unable to slow down that thinking at bedtime, you may find that it is virtually impossible to lull yourself into a drowsy state. Techniques for controlling intrusive thoughts allow people to assert their influence over their thinking, turning down the volume of the chatter, and drifting back to sleep. 

Problematic Emotions

Emotions are not problematic in and of themselves, but sometimes emotional problems present during the day profoundly affect the quality of our sleep. Excess stress and anxiety can activate the central nervous system throughout the day, such that it is hard to wind down at night. Depression can result in lethargy and increased sedentary activities, such that people find they are not tired when it comes time to sleep. By targeting the emotional problems themselves, often there is no need to directly target insomnia. 

Learn more about the most current research in the area of insomnia and sleep disorders