How to Treat Insomnia with Cognitive Behavioral Therapy

Explore this Article

methods

1Conducting a Self-Analysis of Your Sleep Pattern

2Using Cognitive Behavioral Therapy Approaches

3Finding Help

Other Sections

Expert Q&A

Related Articles

References

Cognitive behavioral therapy is a method of addressing insomnia without medication. To begin, you should conduct a self-analysis of your sleep pattern. Once you have a better idea of what is the root cause of your insomnia, you can address it with various cognitive behavioral approaches including stimulus control, sleep restriction, and paradoxical intention. You can try these methods at home, or with the help of a therapist.

Steps

Method 1

Method 1 of 3:

Conducting a Self-Analysis of Your Sleep Pattern

1. 
   1
   Note the presence of other medical, psychological, or sleep disorders. If you are suffering from a major psychological problem like anxiety disorder, major depression, substance abuse, or post-traumatic stress disorder, it could be affecting your sleep. Likewise, medical issues like diabetes, chronic pain, and disorders of the thyroid can also impact sleep patterns. You should address these underlying issues with your doctor before beginning cognitive behavioral therapy.
2. 
   2
   Keep a sleep journal for two weeks. In order to learn more about your personal sleep pattern, you will need to journal about it for at least one, but preferably two, weeks. Take notes on the time you get into bed, the time you fall asleep, how many times you wake up during the night, how long you stay awake for during nighttime wake-up episodes, and the time you wake up in the morning.

   • Be sure to take notes on if and when you use caffeine, alcohol, and tobacco.
   • Include times you eat meals and snacks.
   • Don’t forget to take notes on the time and duration of any naps you take during the day.
3. 
   3
   Take notes on areas that need to be changed. Do you find you are waking up multiple times each night when you drink alcohol before bed? Do you have a harder time falling asleep after a day that included an afternoon nap? Does eating certain foods or drinking caffeine seem to affect your sleep pattern? Carefully examine your sleep journal and make notes on what you can change to positively affect your sleep.
4. 
   4
   Carefully write down your thoughts about sleep. When you are lying in bed at night, while you are washing the dishes in the afternoon, or when you are at work, take careful notes on what these thoughts are. When they happen at night, they are called “excessive nocturnal mentation.”

   • These thoughts can include musings such as, “I will never be able to get my work done tomorrow if I can’t fall asleep by ten o’clock!”
   • Such thoughts can upset and arouse you, preventing sleep and causing negative moods.
5. 
   5
   Examine how your lifestyle might be affecting your sleep. For example, are you working out at 9pm and expecting to be asleep by 11pm? Do you stay up late watching television and then stress about falling asleep on time so you can make it to work the next morning? Take notes on behavioral patterns that might be affecting your sleep patterns.
6. 
   6
   Evaluate your stress level. Stress is often a key factor in the development of insomnia. It can prevent you from falling asleep, staying asleep, and getting a truly restful night of sleep. Take notes on what factors in your life are causing you stress.

   • Common stressors that affect sleep can include work, family obligations, finances, and social pressures.
   Advertisement

Method 2

Method 2 of 3:

Using Cognitive Behavioral Therapy Approaches

1. 
   1
   Try stimulus control therapy. This cognitive behavioral therapy approach includes removing stimuli that might prevent you from sleeping. For example, you can try using the bed only for sex and sleep and removing stimuli such as television or reading books before bed. This approach also includes avoiding naps, and leaving the bedroom after 20 minutes of trying to fall asleep without success and returning to bed only when you are actually sleepy.
2. 
   2
   Experiment with sleep restriction. Lying in bed awake is a bad habit that contributes to poor sleep. Sleep restriction is designed to eliminate extensive awakenings that occur in the middle of the night. Examine your sleep journal and determine how many hours per night you are actually sleeping. Begin by permitting yourself to be in bed only for the amount of hours you actually sleep each night. For example, if you are usually in bed for 8 hours but sleep only six hours, permit yourself to be in bed for only six hours each night.

   • Extend the time spent in bed by 15 to 30 minutes each week.
   • You might also practice getting up any time you lie in bed for more than about 15 minutes at a time. Don't watch the clock, though—just use your internal clock to help you keep the time. Do something relaxing until you start to feel drowsy.
3. 
   3
   Improve your sleep hygiene. Examine the lifestyle issues you identified earlier, such as drinking too much caffeine late in the day, taking naps, drinking alcohol in the evenings, or not exercising regularly. Make an effort to modify or eliminate these behaviors, as they may be contributing to your insomnia.
4. 
   4
   Sanitize your sleep environment. Creating an environment conducive to sleep can help treat, or even eliminate, insomnia. Making sure your room is dark, quiet, and distraction-free is a great place to start. Consider room-darkening window coverings, eliminating noise from radios or televisions, and keeping the temperature comfortable - not too warm, not too cold.
5. 
   5
   Practice paradoxical intention. Allowing yourself to remain passively awake, also referred to as paradoxical intention, means avoiding efforts to fall asleep. Go to bed and try to stay awake! This will decrease performance anxiety about having to fall asleep.
6. 
   6
   Avoid watching the clock. Clock watching can cause stress and further exacerbate your insomnia. Try turning your clock around backwards to that you cannot see the time. This will still allow you to use the clock as an alarm.
7. 
   7
   Consider meditation. Meditation can help patients suffering from insomnia address their sleeplessness. Mindfulness meditation in particular has been shown to help alleviate insomnia in some patients.

   • An alternative might be guided imagery. This is a form of meditation where directed thoughts and suggestions guide your imagination to a more focused, relaxed state. The guidance can come from scripts, tapes, or an instructor. This process can be especially helpful for people who have a lot of active thoughts disrupting their ability to sleep.
   Advertisement

Method 3

Method 3 of 3:

Finding Help

1. 
   1
   Talk to your doctor. While you can practice cognitive behavioral therapy approaches at home, sometimes it is necessary to seek the help of a medical professional. Ask your doctor about options for addressing your insomnia, and then contact your insurance company to see what therapies and specialists might be covered by your insurance plan.

   • Try saying, “Dr. Barnes, I am really struggling with insomnia. I am interested in options other than medication, such as cognitive behavioral therapy. Do you have any suggestions for medical professionals who might be able to help me?”
2. 
   2
   Seek out a behavioral sleep medicine provider. While the number of certified behavioral sleep medicine specialists is limited, they do exist in some areas. Check out the Society of Behavioral Sleep Medicine website to find a provider near you.
3. 
   3
   Consider a therapist specializing in cognitive behavioral therapy. There are mental health professionals who specialize in cognitive behavioral therapy who may be able to help you with your insomnia. Preferably, find someone who practices cognitive behavioral therapy for insomnia (CBTI). Contact your insurance provider to find out what providers are covered by your plan. Then call several providers and ask if they have experience treating insomnia using cognitive behavioral therapy approaches.
   Advertisement

Expert Q&A

Search

Add New Question

• Question

  What is CBTI?

  

  Jeremy Bartz, PhD
  Clinical Psychologist

  Dr. Jeremy Bartz is a Clinical Psychologist in private practice based in Los Angeles, California. Dr. Bartz specializes in treating depression, anxiety, OCD, mind-body syndromes, chronic pain, insomnia, relationship difficulties, attachment trauma, and resolving the effects of narcissistic trauma. He received a Ph.D. in Counseling Psychology from Brigham Young University and completed a fellowship In Pain Psychology at Stanford's premier pain management clinic.

  

  Jeremy Bartz, PhD

  Clinical Psychologist

  Expert Answer

  CBTI is cognitive behavioral therapy for insomnia. It works by modifying cognitions and behaviors in a way that's aligned with the best science we have on sleep.

  Thanks! We're glad this was helpful.
  Thank you for your feedback.
  If How.com.vn has helped you, please consider a small contribution to support us in helping more readers like you. We’re committed to providing the world with free how-to resources, and even $1 helps us in our mission.Support How.com.vn

  YesNo

  Not Helpful 0Helpful 0
• Question

  How does CBTI work?

  

  Jeremy Bartz, PhD
  Clinical Psychologist

  Dr. Jeremy Bartz is a Clinical Psychologist in private practice based in Los Angeles, California. Dr. Bartz specializes in treating depression, anxiety, OCD, mind-body syndromes, chronic pain, insomnia, relationship difficulties, attachment trauma, and resolving the effects of narcissistic trauma. He received a Ph.D. in Counseling Psychology from Brigham Young University and completed a fellowship In Pain Psychology at Stanford's premier pain management clinic.

  

  Jeremy Bartz, PhD

  Clinical Psychologist

  Expert Answer

  A CBTI practitioner will give you an assessment to help you figure out what you're doing wrong and give you tips on how you can optimize your sleep. For instance, one CBTI intervention is to not lie in bed awake for more than 15 minutes. They'll also help hold you accountable to making these changes.

  Thanks! We're glad this was helpful.
  Thank you for your feedback.
  If How.com.vn has helped you, please consider a small contribution to support us in helping more readers like you. We’re committed to providing the world with free how-to resources, and even $1 helps us in our mission.Support How.com.vn

  YesNo

  Not Helpful 0Helpful 0
• Question

  How long does CBTI take?

  

  Jeremy Bartz, PhD
  Clinical Psychologist

  Dr. Jeremy Bartz is a Clinical Psychologist in private practice based in Los Angeles, California. Dr. Bartz specializes in treating depression, anxiety, OCD, mind-body syndromes, chronic pain, insomnia, relationship difficulties, attachment trauma, and resolving the effects of narcissistic trauma. He received a Ph.D. in Counseling Psychology from Brigham Young University and completed a fellowship In Pain Psychology at Stanford's premier pain management clinic.

  

  Jeremy Bartz, PhD

  Clinical Psychologist

  Expert Answer

  I've had patients who were able to totally cure their insomnia after 2 sessions—they just needed to know what to do to get the ball rolling. In general, though, it takes anywhere from a few weeks up to about 3 months.

  Thanks! We're glad this was helpful.
  Thank you for your feedback.
  If How.com.vn has helped you, please consider a small contribution to support us in helping more readers like you. We’re committed to providing the world with free how-to resources, and even $1 helps us in our mission.Support How.com.vn

  YesNo

  Not Helpful 0Helpful 0

Ask a Question

200 characters left

Include your email address to get a message when this question is answered.

Submit

Advertisement