CBT for Insomnia (CBT-I) in Atlanta

You’re exhausted all day, and wide awake the moment you lie down. There’s a treatment for exactly that.

Maybe you fall asleep easily and then find yourself awake at 3am, watching the hours go. Maybe you lie down already braced for another bad night. Maybe you’ve started dreading bedtime, or doing the math on how little sleep you’ll get if you fall asleep right now. Maybe you’ve tried everything you’ve read about — the earlier bedtime, the darker room, the phone left in the kitchen — and you’re still awake.

You don’t have to keep white-knuckling your way through it. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a structured, short-term therapy for sleep itself, and we offer it here in Atlanta.

What CBT-I is

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. CBT-I is a therapy that helps you work through the thoughts and behaviors that get in the way of good sleep — not with general advice, but with a plan built around your own nights.

Medication can be helpful for getting better sleep. CBT-I is as effective as medication for insomnia, which means it’s also a way to avoid the side effects that can come with medication. Treatment is typically 6 to 8 sessions, though it may be more or fewer depending on your lifestyle, how closely you’re able to follow the treatment, and any other mental health concerns you’re carrying alongside the sleep.

This is a short course of therapy with a clear beginning and end, not something you sign up to indefinitely.

What happens in the sessions

The first session is an assessment.Your therapist asks for an overview of your sleep — your daytime routine as well as your nighttime one — and screens you for symptoms of other sleep disorders. CBT-I isn’t a treatment for other sleep disorders, so if your therapist suspects something else is going on, they’ll recommend you see a physician for a sleep study. You’ll leave with a sleep log to fill in before you meet again.

The second session is psychoeducation.You’ll go over the science of sleep, basic sleep hygiene, and what might be adding to your sleep problems, then look at your sleep log together to set a bedtime and a wake-up time. Two pieces of the work usually start here:

• Stimulus controlhelps your bed become associated with sleep and rest again — using your bed only for sleeping and sex, getting into it only when you’re sleepy, getting out of it when you can’t sleep, and getting up at the same time every day.
• Sleep efficiency training means bringing your time in bed closer to the time you actually spend asleep. This part can be hard at first, because in the short term it can mean less sleep while you build your sleep drive and adjust.

The middle sessionsadd relaxation techniques to practice during the day and at night, and CBT tools for the sleep-related thoughts that keep you awake — thought logs and other ways of reframing them. You’ll also look honestly at what’s getting in the way of following the plan and troubleshoot it together. Every session, you review your sleep log and adjust your bedtime and rise time from what it shows.

The final session is relapse prevention— how to hold on to your new sleep habits, and what to do if insomnia turns up again later.

Who CBT-I tends to help

• Adults whose sleep problems have lasted months, not days
• People who’d rather not use sleep medication, or want to rely on it less
• Anyone whose mind speeds up at bedtime, or who now dreads going to bed
• People whose insomnia sits alongside anxiety, stress, or burnout

Please don’t think your sleep problem is too small or too stubborn to bring to us. If CBT-I turns out not to be the right fit, we’ll tell you what we think would help instead.

As a result of CBT-I, you may find yourself:

• Falling asleep without a fight, and getting back to sleep more easily
• Going to bed without dread
• Having tools for the nights that still go badly
• Getting your days back — your focus, your patience, your energy

Emily has written more about what CBT-I looks like session by session on our blog. You can also read about Cognitive Behavioral Therapy more broadly, which several of our clinicians use.

Take the next step

The easiest place to start is a free 15-minute phone consultation — a short conversation, with no obligation, to talk about your sleep and whether CBT-I fits. You can email Emily Hood at emily@innerbalanceatlanta.com or text 770-376-7521, or reach our intake coordinator at info@innerbalanceatlanta.com.