Cognitive behavioural therapy for insomnia, or CBT-I, is a form of therapy designed to address unhelpful behaviours and thoughts regarding sleep. It is safe, evidence-based and effective for treating insomnia. It is considered first-line therapy for insomnia, which means we should be trying this first before trying other treatment options for sleep, including sleeping pills. It can be difficult to find a provider who offers CBT-I however, as it’s not a common skill set for many practitioners.
Recommendations are tailored to individual patients and may include:
- Sleep hygiene
In general, these are recommendations to help “set the stage” for healthy sleep. For a brief overview, please see our other blog post on “sleep hygiene”.
- Stimulus control therapy
This generally refers to keeping the bed and bedroom only for sleep (eg. Not watching TV or doing work in bed), going to bed and getting up at the same time every day, avoiding napping during the day, going to bed only when sleepy, and getting out of bed if you’re not falling asleep.
- Sleep restriction therapy
This type of therapy should only be done under supervision of a trained healthcare provider, as it can be potentially dangerous for some people. In general, it refers to restricting the amount of time in bed for a period of time, and gradually lengthening the bed time which can help reset the circadian sleep-wake rhythm over time.
- Cognitive restructuring
This involves examining and re-balancing the dysfunctional thoughts and ideas we have regarding sleep, and allows us to address the “hyperarousal” that our bodies can develop over time when we are not sleeping well.
- Relaxation Techniques
This also addresses the “hyperarousal” issue and can help to calm the racing or overactive mind. There are many different techniques available, and can include breathing techniques, progressive muscle relaxation, meditation, or “clear-your-head” time.
To see one person’s experience with sleep restriction therapy as part of a CBT-I program, follow the link below:
To learn more about these and other strategies to help restore restful sleep, contact Pacific Sleep to book an in-person, phone or virtual appointment with Dr. Houwing.
