What is Cognitive Behavioral Therapy for insomnia?
Insomnia is a complaint of a difficulty falling asleep, staying asleep, or non-restorative sleep that has daytime consequences. We divide insomnia disorder into those that don’t seem to be associated with other medical, psychiatric or other sleep problems—that’s called “primary insomnia”—from insomnia that’s accompanied by a medical problem, a psychiatric problems, or other sleep problem and we call that “co-morbid insomnia”.
In general there are two approaches to insomnia treatment: those are use of Cognitive Behavioral Therapy (CBT) or use of medications, either prescribed or non-prescribed. CBTi itself involves two main components. The first is the cognitive component which involves adjusting thoughts that are non productive for sleep. These are the kinds of thoughts that people might have like “I’m never going to sleep again” or “ The reason why I’m not sleeping is because I have a brain tumor” or “If I don’t get to sleep in the next 15 minutes, I’m going to be a complete mess tomorrow and screw up that presentation and get fired.” These kinds of thoughts, unfortunately, have a tendency to develop a life of their own in the middle of the night when people are lying in bed and they’re unable to assess whether they’re realistic or not. The cognitive part teaches people how to substitute more realistic thoughts for these less realistic thoughts.
The second piece of CBTi is a behavioral component; it involves adjusting a variety of things–including adjustment to bedtime and wake time, maladaptive strategies that people may have used, like using excess caffeine or alcohol, speeding too much time in bed awake and getting more anxious, becoming increasingly physically stressed and tense, etc.. These behavioral techniques involve adjustment of bedtime and wake time, avoidance of habits that are inappropriate for sleep and finally methods to learn how to relax in the sleep setting. These might include hypnosis, meditation, progressive muscle relaxation, and other techniques for psychological and physical relaxation in this setting that is generally associated with a tremendous amount of stress, of tension, and of anxiety.
Of course, all this assumes that the individual has sought advice from their physician about their insomnia, because insomnia can be the tip of the iceberg of a variety of other medical, psychiatric or sleep problems, which may be very easy to address. However, CBTi or sleep medications may not be the best approach for all insomnia complaints so, it’s really important to have somebody to help you think through the various causes of your sleep disturbance before you start getting into treatment discussions.
Related Questions
- What is stress and how can it affect sleep?
- Are there any associations between insomnia and memory loss?
- How can one clear their mind in order to fall asleep?
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