Insomnia, When You Can’t Fall or Stay Asleep

Sleep is vital for both our minds and bodies. Without it, it is extremely difficult to optimally function throughout the day. A good night’s rest is important to help us feel good, complete responsibilities, and function the next day. However, over 30% of individuals suffer from a sleep disorder that interferes with getting a good night’s sleep.

If you have insomnia, you may have trouble falling asleep or staying asleep. Maybe you feel dissatisfied with the quality or quantity of sleep you are getting each night. Your sleep disturbance may be causing you feelings of anxiety, annoyance, or frustration. If any of these symptoms sound familiar, you are not alone. A bad night’s sleep here and there is very typical. When these symptoms become more chronic and ongoing, you may have insomnia.

As you are lying in bed wide awake, it may feel as if nothing can help. It is likely a very distressing experience. The great news is that  sleep therapy from a therapist trained in cognitive behavioral therapy for insomnia (CBT-I) may be the answer you are looking for and your solution for a good night’s rest.



What Is CBT-I?

Cognitive behavioral therapy for insomnia is a form of cognitive behavioral therapy (CBT). It is an evidence-based approach that is specifically used to tackle the symptoms of insomnia. This individualized, hands-on psychological approach is the most effective treatment for insomnia. Specifically, this type of therapy helps address your behaviors and thinking patterns that contribute to your insomnia. As the American Academy of Sleep Medicine puts it, CBT-I helps you develop habits that promote a healthy sleeping pattern by changing your actions or thoughts that are interfering with your ability to sleep.



How Will CBT-I Help My Insomnia?

The core principle of CBT is that our thoughts control our reactions and behaviors. CBT-I applies this principle to how you think and feel about sleep, suggesting that the way you think about and approach sleep impacts your ability to fall and stay asleep. Take this scenario as an example:

Every night before bed you feel anxious. Before getting into bed each night, you think to yourself “I won’t be able to fall asleep.” Now, you are staring at the clock and watching the hours go by. You toss and turn all night, thinking about how your day tomorrow will be ruined because you didn’t have a good night’s rest. You eventually get out of bed and it is the next day. You find it hard to function at your best, are in a bad mood, and feel tired. 

Now, let’s change the way you think and approach sleep in the next scenario:

It is approaching your bedtime and you feel relaxed. You have done things during the day to help you relax. You know that 8 hours is not a magic number, that sleep will come, and that you will get the sleep you need. You get into bed and close your eyes, and within 15 minutes you fall asleep. You go to bed knowing that if you are not asleep within 20 minutes you have a tool box of different tools you can use to help with insomnia.

This is a very brief example of a shift in thinking and behaviors that can happen when working with a sleep therapist for insomnia.

can't fall asleep help sleep therapy


Sleep Therapy

During sleep therapy, our psychologists will work with you to learn what is contributing to your sleeping troubles. We will collaborate to develop strategies tailored to you to improve your quality and quantity of sleep. This will be done by identifying the thoughts, feelings, and behaviors that contribute to your sleeping difficulties. This multicomponent sleep therapy treatment will combine cognitive, behavioral, and educational approaches.

During sleep therapy you will learn information about sleep and changes that you can make to improve your sleep. Your sleep therapist may teach you about an array of different topics related to sleep. These may include but are not limited to:

  • Diet
  • Exercise
  • Sleeping environment
  • Sunshine
  • Napping
  • Wake up times

Cognitive Interventions

Cognitive interventions aim to change the harmful and incorrect thoughts we have about sleep. An example of a cognitive intervention is cognitive restructuring.

Cognitive reconstructing identifies, challenges, and alters thoughts and beliefs that contribute to insomnia. Many times our thoughts about sleep get in the way with our ability to be a good sleeper. First, your therapist will work with you to identify the negative thoughts and beliefs that contribute to your insomnia. Common thoughts include needing to get 8 hours to function well, fear of not getting enough sleep leading to terrible outcomes, and thoughts about limited productivity due to lack of sleep. After identifying the unhelpful thoughts, your therapist will work with you to challenge these beliefs. Once the thoughts are identified and challenged, they are replaced with more helpful ways of thinking that promote better sleep. You and your therapist will come up with statements that you can say to yourself to reduce anxiety and concerns about sleep.

Behavioral Interventions

Behavioral Interventions are interventions that encourage relaxation and healthy habits related to sleep.

Your bed may have become paired with anxiety and frustration after many nights lying in bed unable to sleep. Your brain may connect lying in bed with these feelings. With behavioral interventions, your therapist will work with you to create more positive associations resulting in better sleep. Your therapist will help you with tools to unpair the connection of negative emotions to your bed.

Relaxation training may be another component to treatment of insomnia. Relaxation techniques are found to increase the body’s natural relaxation response by reducing negative thoughts and tension in the mind and body. Your sleep therapist may teach you techniques such as:

  • Breathing exercises
  • Progressive muscle relaxation
  • Guided Imagery
  • Autogenic training
  • Meditation

Sleep restriction may also be used as a behavioral intervention. This technique works to increase the drive to sleep by limiting the amount of time spent in bed. For example, if you are lying in bed for 12 hours but only sleeping for 7 hours, an insomnia therapist will limit the bedtime to be more representative of the time you are actually sleeping. A sleep log may be completed to help with this as well.



Does CBT-I Work for Insomnia 

The quick answer is yes. In fact, it is deemed a first line treatment for insomnia. Research has found that Cognitive Behavioral Therapy for Insomnia has many benefits including:

  • Less time to fall asleep
  • More time spent asleep
  • Waking up less during sleep
  • Maintained benefits over time

CBT-I has even been shown to be at least as effective to even more effective than medication.



Sleep Therapy: Treatment for Insomnia 

If you find yourself struggling with falling or staying asleep, you may benefit from seeing a therapist that has specific training in insomnia treatment. At Best Within You Therapy & Wellness, our therapists are trained in Cognitive Behavioral Therapy for Insomnia and have extensive knowledge and experience in the field. To schedule a free consultation for sleep therapy you can visit this link, and you can also read more about therapy for insomnia.

If you are not ready to meet with a sleep therapist yet, some things you can think about trying on your own include:

  1. If you are feeling very anxious when trying to sleep get out of your bed and do something relaxing
  2. Don’t stress over getting a perfect night sleep. Everyone’s sleep needs are different and 8 is not a magic number
  3. Consider a sound machine and blackout curtains
  4. Try to keep a consistent wake up time (within an hour)
  5. Stay away from using alcohol to help you fall asleep. Sleep is less restorative with alcohol

The sleep foundation also has helpful resources and information about sleep.

Thank you to Maura Johnston, Best Within You Therapy & Wellness intern, for help with this blog post