Living with insomnia can be a difficult.
There are effective treatments available that can help you to fall asleep faster, stay asleep, and feel more rested during the day.
Cognitive Behavioral Therapy for insomnia, (CBT-I or CBTI) is an evidence-based method to support you to sleep better. It can also be described as a form of mind or sleep training. The more you actively work on the techniques to be better the results will be.
The treatment works by focusing the connection between our thoughts and behaviour and our sleep patterns. We can help you to identify thoughts, feelings, and behaviors that are contributing to the symptoms of insomnia. Thoughts and feelings about sleep are examined and tested to see if they’re accurate. Behaviors and habits are looked into to determine if they promote sleep or if they are contributing to the problem. We can support you by reframing misconceptions and challenges.
Treatment often takes from 2-8 sessions1, although the length may differ depending on a person’s needs.
CBT-I combines several different approaches. Sessions may include cognitive, behavioral, and educational components.
Cognitive interventions: Change inaccurate or unhelpful thoughts about sleep.
Behavioral interventions: Relaxation training,meditaton, self-hypnosis, stimulus control, and sleep restriction promote relaxation and help to establish healthy sleep habits.
Educational interventions: Providing information about the connection between thoughts, feelings, behaviors, and sleep.
Worrying about sleep may lead to spending excessive time in bed to trying to force sleep. Worry and too much time in bed can make falling and staying asleep more difficult. This can lead to anxiety and frustration and create a negative habits and pattern in relation to sleep.
Cognitive restructuring breaks this cycle through identifying, challenging, and altering the thoughts and beliefs that contribute to insomnia.
Thoughts and beliefs that may be considered during treatment include worry and anxiety about past experiences of insomnia and quality, and worry about daytime fatigue or other consequences of poor sleep.
Relaxation techniques , meditation and self-hypnosis can help reduce the racing thoughts and tension that often accompany lying in bed awake.
These techniques can increase the body’s natural relaxation response5, which is helpful for the body and mind.
The best relaxation techniques are those that can be reasonably incorporated into a person’s routine.
Here are a few relaxation techniques commonly taught in CBT-I:
- Breathing exercises: Many different breathing exercises may be taught. Research has show that slow deep focused breathing can slow your heart rate and reduce feelings of anxiety, anger, and depression6.
- Progressive muscle relaxation (PMR): PMR also know as a body scan is a technique that involves relaxing different muscle groups or parts of the body.
- Autogenic training: This technique adjusts focus to different parts of the body and notices specific sensations. A person may focus on sensations such as heaviness, warmth, or relaxation.
- Biofeedback: Biofeedback uses technology to help monitor certain processes in the body such as brain waves, heart rate, breathing, and body temperature7. Using the information provided by electronic devices, people may begin to learn to have more control over these processes.
- Meditation, Hypnosis & Guided imagery: Learning to focus attention through meditation has demonstrated a variety of health benefits8, including reduced stress, anxiety, and increased relaxation. Meditation may also involve practices that combine focused attention with movement, such as yoga and tai chi.
Good sleep hygiene is vital to positive sleep. Sleep hygiene involves practices that encourage and support sleep, while decreasing or eliminating those that discourage sleep.
The American College of Physicians recommends that all adult patients receive CBT-I as a first-line approach10. In some patients, CBT-I is more effective than medications11.
Sleep training can take time to learn and practice the skills learned in treatment. Some techniques, like stimulus control and sleep restriction, often help to adjust sleep habits slowly.
Tips for Sleeping With Insomnia
The following are some basic sleep hygiene tips.
- Try to stick to a regular sleep schedule to maintain a rhythm and make it easier to fall asleep.
- If you cannot sleep get out of bed and find something relaxing to do until you feel tired again.
- Create a nightly ritual: Give yourself enough time to get ready for bed – the longer the better ideally 2 hours. Turn off your electronics early and find some relaxing activities that help you wind down before sleep.
- Exercise can help you sleep better.
- Avoid eating, too close to bedtime.
- Alcohol and caffeine can disrupt sleep patterns so maybe an idea to quit or skip for a while until you get your sleep patterns on track.
- Include a warm drink such as herbal tea in your bedtime routine.
- Lavender is a a wonderful scent that can put you in the mood for sleep.
- Try meditation and self- hypnosis
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