Chronic insomnia can be a seriously debilitating condition.
Your body simply is not built to survive on anything much less than 7 or 8 hours of sleep a night, and continual sleep deprivation is one of the worst things that can happen to a person’s brain.
But it doesn’t have to be this way.
With the help of cognitive behavioral therapy, many insomniacs can see real, noticeable improvements within the space of just a couple weeks – often without the help of sleep aids, too!
Here’s how it works.
What Is Cognitive Behavioral Therapy?
Cognitive behavioral therapy is a pretty widespread method of combatting various mental health concerns.
It’s not super complicated – it just involves meeting with a specialist who will help you use your thoughts to influence your behaviors.
Why do you need to see a doctor to teach you how to think?
Well, the thing is, a lot of people have all kinds of unhealthy mental habits that can result in serious medical conditions.
For most people, insomnia really is “all in your head” – but that little factoid isn’t exactly helpful when it’s 4 AM and you’re still looking for a wink of sleep.
That’s why many people suffering from insomnia stand to benefit from working with an actual person, rather than just trying to sort this stuff out themselves.
After starting cognitive behavioral therapy for insomnia (CBT-I), many people start to see effects within the space of just a couple of sessions.
So unlike mental health concerns like chronic depression, which may never entirely go away, many chronic insomniacs can entirely (or almost entirely) beat their symptoms once and for all.
Cognitive Behavioral Therapy vs Sleeping Pills
CBT-I has a number of advantages over the typical pharmaceutical approach to insomnia, which is just to assign you a whole mess of sleeping pills that will more or less beat your body into submission.
Many people don’t exactly cherish the idea of being dependent on pills to do something so basic as sleep, and in any case, psychological treatments are often more effective in the long run anyway.
So if you’ve been using sleeping pills already, CBT-I will help free you of that necessity.
And if you’re not already on sleeping pills, it’ll help you get the sleep you need without having to resort to pharmaceuticals.
However, depending on the patient, some people may benefit most from a combination of both therapy and pills.
It all depends on your specific needs.
Sleep Restriction Therapy
So, if you’re thinking about seeing somebody to work out your chronic sleeplessness, you probably want to know what to expect.
What’s this doctor going to do to you, anyway?
Well, one of the most basic components of CBT-I is actually one of the most controversial – a technique known as “sleep restriction therapy.”
A lot of insomniacs’ first instinct is to try overcompensating for the amount of sleep they’re missing out on.
So if it’s taking you several hours to get to sleep, you might naturally assume that the solution is to push your bedtime several hours back to make up for the difference.
The thing is, though, that’s not really how sleep works.
One of the leading causes of insomnia is worrying about the amount of sleep you’re getting.
By allowing yourself to lie in bed for such prolonged periods of time, you’re training your body to associate the bedroom with stress and frustration instead of sleep.
That’s why CBT-I typically starts by trying to force your body out of those vicious cycles.
If you’ve been sleeping for six hours a night, for instance, sleep restriction therapy might start by cutting down your amount of time in bed to something less than six hours.
It might sound counterintuitive, but it’s what your body needs.
Sleep Hygiene Education
Another major component of CBT-I is something called sleep hygiene education.
This involves developing healthy habits around sleep and bedtime as a way to combat the unhealthy ones you’ve fallen into.
Some basic tips sleep experts tend to talk about include:
- Cutting out naps throughout the day, especially too close to bedtime
- Getting out of bed to do something else if you’ve spent over 20 minutes trying to sleep
- Developing soothing rituals before going to bed
- Limiting use of electronics at night
- Limiting bedroom activities to sleeping and sex
- Avoiding work in the hours before bed
- Getting yourself a comfortable enough mattress
- If you have any gastrointestinal issues, avoiding any large meals within a couple hours of bed
These kinds of habits make it easier for your body to get into the proper state for rest.
Changing How You Think About Sleep
Another vital component to CBT-I involves changing the way you conceptualize your sleep.
For a lot of insomniacs, bedtime can be an extremely stressful time of day.
You’re already sleep deprived, and you know every night is another chance to give yourself a bit of extra sleep.
On top of that, you’re also well aware how terrible your days are if you don’t get the proper amount of rest tonight!
These kinds of mentalities – seeing sleep as something you can make yourself do, rather than something that will happen to you in its own time – are often at the heart of bad insomnia cases.
Therapy can help you develop healthier attitudes towards sleep.
Professionals will often recommend simple relaxation techniques, sometimes alongside basic meditation exercises to clear your mind of all the worries and stray thoughts that keep you stressed out at night.
Keeping a Sleep Diary
Another virtually ubiquitous component of CBT-I is the sleep diary.
These are pretty easy logs that help you and your therapist keep track of your sleep health.
What time did you try going to bed last night, and what time did you actually fall asleep?
How many times did you wake up throughout the night, and how long did these times last?
What time did you wake up in the morning, and what time had you been planning on waking up?
How high-quality was your sleep, and how tired were you throughout the day?
These kinds of questions allow specialists to gauge the kinds of treatments that will work best for you, and also help you keep track of your progress over time.
Crafting the Right Sleep Environment
Another big thing therapists like to talk about during CBT-I is your sleep environment.
Think about your bedroom as a cave – cool and dark.
Studies have shown that cooler temperatures at night – somewhere around 65 degrees Fahrenheit – are ideal for getting to sleep in the least amount of time.
Your body temperature fluctuates somewhat throughout the day, but it really starts to dip as you get closer to the evening.
The coolness of your core helps power down your body for sleep, which is why it’s so important to keep your bedroom at a low enough temperature.
Additionally, keeping your bedroom dark enough is vital if you’re hoping to get decent-quality sleep.
Your body is meant to react to the rising and setting of the sun, after all, and excessive amounts of artificial light in your bedroom can wreak havoc with your daily sleep cycle.
Artificial light delays the release of melatonin into the bloodstream, which means you’re not going to start feeling all that tired until later than you’d probably like.
This means more than just getting a pair of blackout curtains to blot out that sleep light, too.
Any artificial light – especially the blue light that comes from pretty much all electronics – can do some pretty annoying things to your sleep-wake cycle.
This is part of the reason why electronics pair so poorly with a bed.
Not only do they keep you awake with their distractions, but they also disrupt the release of sleep-inducing hormones.
How to Prevent Relapse
CBT-I sessions generally last somewhere around six to eight weeks.
At the end of that period, most people will have made substantial progress against their insomnia, and should no longer be having super restless nights multiple times per week.
That said, insomnia is a tricky disorder.
It often comes on suddenly, and just a couple bad nights can be enough to set you back on that vicious cycle you worked so hard to beat.
At the end of your time with them, your specialist will likely give you some helpful tips on how to prevent relapse.
First of all, don’t try to compensate for lost sleep. If you had a bad night, there’s nothing you can do about that – and trying to balance things out by getting a couple hours the next day is just going to screw with your schedule.
Additionally, if you’ve started using your bedroom for anything other than sleeping and sex after stopping CBT-I, you’ll want to cut out all those extraneous activities ASAP.
Finally, if problems persist, you can try resorting to sleep restriction again.
If even that doesn’t work, it’s time to schedule another appointment.
You should now have a pretty good idea of what cognitive behavioral therapy looks like when dealing with insomnia.
Seeing a specialist about things like this can be uncomfortable for a lot of reasons, but always keep in mind how important your sleep is.
Trouble sleeping is a serious medical concern, so you should treat this just like any other medical issue.
There are some problems we simply are not strong enough or smart enough to solve on our own.
Never be afraid or ashamed to seek help.