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Insomnia is a common problem characterized by trouble
falling asleep, staying asleep or getting restful sleep. Cognitive
behavioral therapy for insomnia is an effective insomnia treatment for
chronic sleep problems.
Cognitive behavioral therapy for insomnia is a structured program that
helps you identify and replace thoughts and behaviors that cause or
worsen sleep problems with habits that promote sound sleep. Unlike
sleeping pills, cognitive behavioral therapy for insomnia helps you
overcome the underlying causes of your sleep problems.
How does cognitive behavioral therapy for insomnia
work?
The cognitive side of cognitive behavioral therapy for insomnia teaches
you to recognize and change beliefs that affect your ability to sleep.
The behavioral part of cognitive behavioral therapy for insomnia helps
you develop good sleep habits and avoid behaviors that keep you from
sleeping well.
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Cognitive behavioral therapy for insomnia contains
one or more of the following elements:
Sleep education. To make effective changes,
it's important to understand the basics of sleep — for example,
understanding sleep cycles and learning how beliefs, behaviors and
outside factors can affect your sleep.
Cognitive control and psychotherapy. This
type of therapy helps you control or eliminate negative thoughts and
worries that keep you awake. It may also involve eliminating false or
worrisome beliefs about sleep, such as the idea that a single restless
night will make you sick.
Sleep restriction. Lying in bed when you're
awake can become a habit that leads to poor sleep. Limiting the amount
of time you spend in bed can make you sleepier when you do go to bed.
That way you're more likely to fall asleep and stay asleep.
Remaining passively awake. This involves
avoiding any effort to fall asleep. Paradoxically, worrying that you
can't sleep can actually keep you awake. Letting go of this worry can
help you relax and make it easier to fall asleep.
Stimulus control therapy. This method helps
remove factors that condition the mind to resist sleep. For example, you
might be coached to use the bed only for sleep and to leave the bedroom
if you can't go to sleep within 15 minutes.
Sleep hygiene. This method of therapy
involves changing basic lifestyle habits that influence sleep, such as
smoking or drinking too much caffeine late in the day, drinking too much
alcohol, or not getting regular exercise. You may be told to avoid
napping and taught to maintain a consistent sleep schedule. It also
includes tips that help you sleep better, such as ways to wind down an
hour or two before bedtime.
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Relaxation training. This method helps you
calm your mind and body. Approaches include meditation, hypnosis and
muscle relaxation.
Biofeedback. This method allows you to
observe biological signs such as heart rate and muscle tension. Your
sleep specialist may have you take a biofeedback device home to record
your daily patterns. This information can help identify patterns that
affect sleep.
Sleep diary. To understand how to best
treat your insomnia, your sleep therapist may have you keep a detailed
sleep diary for one to two weeks. In the diary, you'll write down when
you go to bed, when you get up, how much time you spend in bed unable to
sleep, total sleep time and other details about your sleep patterns.
The most effective treatment approach may combine several of these
methods.
Cognitive behavioral therapy vs. pills
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Some newer sleeping medications have been approved for long-term use.
But they may not be the best long-term insomnia treatment.
Sleep medications can be a very effective short-term treatment — for
example, they can provide immediate relief during a period of high
stress or grief.
Cognitive behavioral therapy for insomnia may be a good treatment choice
if you have long-term sleep problems. You may want to try it if you're
worried about becoming dependent on sleep medications, if medications
aren't effective or if they cause bothersome side effects.
Unlike pills, cognitive behavioral therapy for insomnia addresses the
underlying causes of insomnia rather than just relieving symptoms. But
it takes time — and effort — to make it work. In some cases, a
combination of sleep medication and cognitive behavioral therapy for
insomnia may be the best approach. |