Saturday, July 3, 2021

Cognitive Behavioral Therapy for Insomnia: How Effective is CBT-I?

Living with sleep disorders or insomnia can be challenging. There are many treatments available. One of the most effective treatments for insomnia is cognitive-behavioral therapy. CBT can improve your sleep habits and help you fall asleep faster, stay asleep, and feel more rested during the day.

Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT)

What is the Best Therapy for Insomnia?

Our bodies follow a natural circadian rhythm that prompts us to enter a sleep cycle. The body naturally promotes sleep initiation when it releases chemicals like melatonin and adenosine. However, for some people, getting enough sleep can be difficult and challenging due to insomnia.

Insomnia is a common sleep disorder that can make falling asleep difficult to achieve, or cause you to wake up too early and not be able to get back to sleep.

There are many treatments available. Cognitive-behavioral therapy (CBT) is considered one of the most effective treatments for insomnia and sleep deprivation.


Cognitive Behavioral Therapy for Insomnia

Cognitive-behavioral therapy for insomnia (CBT-I) is an effective treatment for chronic sleep disorders and insomnia and is usually recommended as a first-line treatment. Depending on your needs, a sleep specialist may recommend some of these CBT techniques:


Stimulus control therapy: This method helps eliminate the factors that prepare your mind to resist sleep. For example, you may be trained to set a consistent bedtime and wake-up time, avoid naps, use the bed only for sleep, get out of bed if you cannot fall asleep within 20 minutes, and only go back to bed when you feel sleepy.


Sleep restriction therapy: It is a behavioral treatment for insomnia that reduces the variance in sleep timing while increasing the depth of sleep.

Lying in bed while awake can become a habit that leads to poor sleep. This method reduces the time you spend in bed, causing partial sleep deprivation, which makes you feel more tired the next night, and once your sleep improves, the time you spend in bed will gradually increase.


Remaining passively awake: It is also known as “paradoxical intention”. This involves avoiding making any effort to fall asleep, ironically worrying that you won't be able to sleep will actually keep you awake, letting go of that anxiety can help you relax and ease your fall asleep.


Healthy sleep habits: This includes changing your basic lifestyle habits that affect sleep, such as smoking, drinking too much caffeine late at night, drinking too much alcohol, or not getting enough exercise.

Healthy sleep habits also include tips to help you sleep better, such as ways to relax an hour or two before bedtime.


Improving the sleeping atmosphere: This method provides techniques to help you create a comfortable atmosphere that helps to sleep, such as keeping your bedroom quiet, dark, and cool, not placing a TV in the bedroom, and keeping the clock out of your eyes.


Relaxation training: This method helps relax your mind and body. Techniques include meditation, visualization, muscle relaxation, and other techniques.


Biofeedback: This method allows you to notice vital signs such as heart rate and muscle tone and shows you how to adjust them. 

A psychologist may ask you to take home a biofeedback device to record your daily patterns. This information may help identify patterns that affect sleep.


How Effective is CBT for Insomnia?

CBT-I is an evidence-based approach to combating the frustrating symptoms of insomnia. It focuses on exploring the connection between the way you think, the things you do, and how you sleep. 

CBT-I is a comprehensive program that helps you identify and replace the thoughts and behaviors that cause or worsen your problems with habits that induce restful sleep. It is a collaborative process and homework is a common component of treatment.

In contrast to sleeping pills, CBT for insomnia helps you overcome the causes of your sleep problems.

Treating insomnia with CBT-I has a number of potential advantages, including fewer known side effects, and a clear focus on treating factors that may be responsible for chronic insomnia in an effort to produce more lasting effects.

The cognitive part of CBT teaches you to recognize and change beliefs that affect your ability to sleep. This type of therapy can help you control or eliminate negative thoughts and fears that keep you awake.

The behavioral part of CBT helps you develop good sleep habits and avoid behaviors that prevent you from sleeping well.

CBT-I is considered effective in both short-term insomnia and chronic insomnia.

According to a 2015 study report published in Annals of Internal Medicine,  patients with chronic insomnia who undergo cognitive behavior therapy can improve their sleep cycle without drugs and without adverse outcomes.  CBT works because it addresses the cause of insomnia and improves sleep without side effects.

Harvard Medical School study suggests that CBT is a more effective treatment for chronic insomnia than prescription sleep medications.


5 Healthy Lifestyle Tips to Overcome Sleep Disorders

Follow these 5 healthy habits to overcome insomnia and sleep disorders and improve sleep cycle:


1. Schedule your bedtime

The human body responds well to a regular schedule. If you fall asleep at the same time every night, you can program your internal body clock to show sleep at about the same time every day.


2. Do physical activity

Daily exercise can promote general well-being and deep sleep. However, when you schedule exercises too close to bedtime, it can lead to sleep deprivation. The body needs time to cool down from vigorous physical activity.


3. Limit electronics use before bed

Exposure to blue light emitted by electronic screens disrupts the body's sleep-wake cycle. To address sleep problems, limit electronics use before bed or at least use a blue light filter after sunset.


4. Adopt effective bedtime rituals

Try to do some rituals before bedtime every night. This might include taking a shower, drinking hot tea, or listening to relaxing music. You can train your body to associate bedtime rituals with the onset of sleep.


5. Seek medical advice

Some medical conditions can impair the onset of sleep and prevent you from sleeping for long hours throughout the night. Seek medical advice for such conditions, and work with your health care provider to develop treatment and coping strategies.

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