Adult Insomnia – Part II
Last time we talked about ways to relieve adult insomnia through sleep hygiene. Now we’re going to talk about adult insomnia and CBT-I.
CBT, of course, stands for cognitive behavioral therapy. The “i” stands for…well, take a guess. CBT-I aims to treat insomnia without the use of sleeping meds. Clinically approved by the NIH, it focuses on replacing the underlying thoughts and habits that are causing the insomnia to begin with.
So How Does It Work?
The cognitive part of CBT-I works on your thoughts. Most people who suffer from chronic insomnia have developed a negative thought pattern that interferes with their ability to either fall asleep or sleep through the night. Since everyone’s thoughts are different, this is the most individualized part of the program. Basically, it works along the same lines as classic CBT.
The behavioral part of CBT-I, however, is highly specialized and can only be done through a therapist who received specific CBT-I training. While it might sound like you can do some of the following on your own, beware: Do not try this at home, no matter how tempting the idea may be.
Sleep Restriction Therapy
Yes, you read that right. The first element of CBT-I is sleep restriction. Your therapist will ask you to start writing a sleep diary, which means jotting down the total amount of time you slept (slept, not tossed and turned) every day for a week. After a week, you’ll be asked to average out the number of hours you slept every day.
So let’s take Jason as an example. After the first week, Jason tallied up all the hours he’d slept and found that he averaged 6 hours a day. When asked, he told his therapist that he needed to wake up every morning at 7 o’clock. So his therapist told him he could not, under any circumstances, go to sleep before 1 o’clock in the morning. The point is to reduce the time Jason spends in bed to the minimum possible in order to reset his body’s internal clock. Once his sleep improves, his therapist will move back his “bedtime.”
Stimulus Control
When someone suffers from insomnia for a long time, their mind can literally resist going to sleep – even if they don’t feel it. Often the first thing you’ll be asked to do is decide on a consistent wake time.
That’s right. The first thing you’ll have to do is decide when you want to wake up and to stick to it. Your therapist might also ask if there are any activities besides sleeping – like reading, playing games, making phone calls – that you do when you’re on your bed. If there are you’ll most likely be asked to stop them so that your mind can begin associating a bed with sleep, not with activity.
Other elements of CBT-I? While these two are the central ones, there are others like relaxation training, biofeedback and, of course, sleep hygiene.
While CBT-I isn’t the easy answer to adult insomnia, it’s a very effective one. And unlike sleeping pills, it’s a solution that lasts.
Do you have experience with CBT-I? Please let us know in the comments below!