How CBT for Insomnia Works
What does CBT for insomnia look like? When a client first sees Silberman, they work on uncovering the client’s current sleep pattern and the factors that are negatively affecting their sleep. They accomplish this by completing sleep logs, for instance.
They talk about a variety of potential issues, such as: “What’s causing them to have these problems at night? Are they tossing and turning because they can’t turn off their brain at night or is it some kind of pain or an environmental stimulus, such as a baby waking you up?” Is smoking one of the culprits? (Smoking is a stimulant, so smoking right before bed can make it tougher to fall asleep.) They ponder whether physiological factors are to blame. For instance, a medication you’re taking might be causing poor sleep.
When treating insomnia, in addition to sleep logs, other techniques include sleep restriction (described later) and reducing any anxious or worrisome thoughts the person may be having around sleep or their life in general.
Sleeping Strategies To Try
Silberman shared the following strategies you can try on your own to improve your sleep.
1. Observe your sleep.
Gathering data is key when trying to treat insomnia or any kind of sleep trouble, Silberman said. In her book, she provides readers with several worksheets to log in your sleep. This is essential because it helps you figure out what habits are hindering your sleep (such as a stressful event, caffeine intake, daytime napping or TV watching) and how long you’re actually sleeping.
In fact, Silberman said that many different things can affect your sleep. At first, sleep or lack thereof seems random. But once you commit your habits to paper, you might notice that the three glasses of wine or two cups of coffee you had led to your sleeping poorly. Maybe another day, you ate a super-spicy meal for dinner, leading to heartburn and little sleep.
When observing your sleep, it’s helpful to consider: what time you went to bed, how long it took you to fall asleep, how often you woke up during the night, what time you finally got up and how many hours you slept. Recording this information each morning for a week helps you spot patterns.
2. Restrict your time in bed.
Sleep studies have shown that sleep restriction is effective for treating insomnia. This is why collecting your sleep data is so important. It gives you a good idea of how long you’re actually sleeping, because you want to be in bed for that number of hours. Lying awake in bed only “increases frustration, anxiety and annoyance with the process,” Silberman said.
“By restricting the amount of time to bed,” she said, you “will start getting more solid sleep.” How do you calculate the time you spend in bed? Just add up the time you’ve actually spent sleeping each night for a week; and divide by seven to get an average time.
Then about 30 minutes to an hour before bedtime, establish a routine that primes your body for relaxation. For instance, you might listen to soothing music, take a warm bath or read a book.
3. Practice good sleep hygiene and habits.
While good sleep hygiene won’t dramatically change your insomnia, it does help you optimize your sleep, Silberman said. Some examples are limiting caffeine and alcohol intake, making your room cool and dark and exercising four or five hours before bedtime.
Other helpful habits include engaging in relaxation techniques and working through any worry thoughts. “In particular it’s important to practice [relaxation techniques] when you’re not anxious or stressed out, so they work better when you need them.”
One way to reduce anxious thoughts is by asking yourself “what’s the evidence for and against these thoughts I’m having,” Silberman said. Not surprisingly, there’s usually “very little evidence for the irrational thought.” Then, you “can come up with an alternative thought or new explanation.”
Again, remember that you do have control over your sleep. Studies have repeatedly shown that CBT is a highly effective treatment for insomnia.
To learn more about sleep specialist and clinical psychologist Stephanie Silberman and her work, please visit her website.
Tartakovsky, M. (2011). The First Line of Treatment for Insomnia That’ll Surprise You. Psych Central. Retrieved on March 12, 2014, from http://psychcentral.com/lib/the-first-line-of-treatment-for-insomnia-thatll-surprise-you/0007004
Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
Published on PsychCentral.com. All rights reserved.