Can’t Sleep? Try Cognitive Behavioral Therapy for Insomnia

Are you haunted by sleepless nights? Do you slog throughout the day, longing to get some sleep, but your brain goes into overdrive the minute you close your eyes? People with chronic insomnia have trouble falling asleep and/or staying asleep and they also might wake up too early in the morning, three nights per week for more than three months.

While medication can be helpful for getting better sleep, Cognitive Behavioral Therapy for Insomnia (CBT-I) is as effective as medication for insomnia, allowing you to avoid side effects that might come with medication.

So, what exactly is CBT-I? CBT-I is a therapy that helps people work through thoughts and behaviors that get in the way of good sleep. CBT-I treatment is typically 6 to 8 sessions but it may be more or less sessions depending on your lifestyle, how closely you follow the treatment, and/or other mental health concerns.

What Happens During the Sessions?

1st Session: Assessment Session – Your therapist will ask for an overview of your sleep issues, including your daytime and nighttime routine. They will also screen you for symptoms of other sleep disorders. CBT-I is not a treatment for other sleep disorders and if your therapist suspects you have a different sleep disorder they will recommend you meet with a physician for a sleep study and other treatment. Your therapist will ask other assessment questions to see if you are a good fit for CBT-I. Before the end of the session, your therapist will assign a sleep log to complete before the next session.

2nd Session: Psychoeducation – Your therapist will provide some psychoeducation on insomnia and help you identify what might be adding to your sleep issues. The two of you will review the science of sleep, basic sleep hygiene, as well as stimulus control and sleep efficiency training. You will also review the results from your sleep log to prescribe bedtime and wakeup times. The two of you will work together on how to proceed with stimulus control and/or sleep efficiency training.

Stimulus Control – Practicing stimulus control helps reassociate your bed with sleeping and rest – This means using your bed only for sleeping and sex, getting into bed only when sleepy, getting out of bed when unable to sleep, and getting up at the same time every day.

Sleep Efficiency Training – Sleep efficiency training means reducing time in bed to time actually spent sleeping - this part can be difficult at first because in the short term it might limit your sleep as you build your sleep drive and adjust to more efficient time in bed.

Remaining Sessions: Relaxation Techniques, Targeting Unhelpful Thoughts, & Adjusting Bedtimes and Rise Times. In following sessions you will go over different Cognitive Behavioral Therapy techniques including ways to target troublesome sleep-related thoughts using thought logs or other reframing techniques. You and your therapist will also go over relaxation techniques to practice throughout the day and/or at night.

Additionally you will explore barriers to following your treatment plan and troubleshoot ways to overcome them. In each session, you will review your sleep log and make any necessary adjustments to your bedtime and/or rise time.

Final Session: Relapse Prevention. Your therapist will use your final session to review how to maintain your new sleep habits including a brief overview of the key strategies and what to do if insomnia emerges in the future.

Want to get started? Email Emily Hood at emily@innerbalanceatlanta.com or text 770-376-7521 to schedule a free 15-minute phone consultation for CBT-I.