What is cognitive-behavioural therapy for insomnia?
Insomnia tends to be triggered by an isolated event or a series of events that cause disruption in our lives.
Although sleep problems during periods of stress or change are normal for most people, there is a large group for whom, even after the event has passed or they have adapted to a change, sleep problems remain.
Insomnia can be difficult to overcome, even after the initial cause has been resolved. This is because we start to pay attention to sleep and develop inappropriate thoughts and behaviours which, in an attempt to help, only cause further harm.
These continued thoughts and behaviours are the cause of most cases of chronic insomnia.
Cognitive behavioural therapy for insomnia (CBT-I) is a set of techniques developed and tested to reformat these thoughts and behaviours. "Cognitive" is just the scientific word for thoughts, while "behavioural" refers to our behaviours.
Sleep education is included in the therapy to correctly structure our thinking about sleep and to re-set the behaviours that negatively affect it.
Having a better understanding of sleep leads to less worry and anxiety, and therefore improves the likelihood of sleep occurring.
This is a scientific term which means "to change the way we think". Cognitive restructuring will address (and help correct) certain ways of thinking that are unrealistic and unhelpful. Cognitive restructuring means replacing negative thoughts with more positive and productive thoughts about sleep. The goal of cognitive restructuring is simple but powerful. By understanding and changing negative thoughts, we can reduce worry and other emotions that initiate the stress response and disturb our sleep. However, cognitive restructuring is not the same thing as pretending that we have no sleep problems, or simply using the power of positive thinking. Rather, cognitive restructuring means learning to think about sleep with the right information.
It is common for people with insomnia to spend too much time in bed while not sleeping. The Sleep Restriction technique reduces the amount of time spent in bed to coincide with the amount of time we are actually asleep. We restrict the time in bed to increase sleep efficiency.
HOW CBT-I WORKS
The CBT-I is held through weekly sessions over a period of 5 weeks.
CBT-I works by addressing the thoughts and behaviours that are the cause of most cases of insomnia.
This is another scientific phrase that aims to make the bed a trigger for sleep. For many people with insomnia, the bed has become a place of wakefulness, with all the negative emotions associated with that. The result? Our brain does not identify our bed as a place to sleep. Stimulus control corrects this by training the mind to see the bed as a place for sleep.
A common complaint among people suffering from insomnia is being unable to sleep because of an active mind, not being able to stop our train of thought. Thus some relaxation techniques are taught during the therapy.
Sleep hygiene is a variety of habits and practices that are important for a good night's sleep.
Cognitive behavioural therapy for insomnia is much more than just sleep hygiene. Although it is always a good idea to practice good sleep hygiene, in cases of chronic insomnia, practising good sleep hygiene is unlikely to lead to improvements on its own. For this reason, sleep hygiene is generally included in CBT-I sessions, but it is not the main focus.
Prevention of relapse
Finally, a good CBT-I course should teach you what to do if your insomnia returns. This will help prevent any future sleep problems from turning into insomnia.