CBT-I
COGNITIVE-BEHAVIOURAL THERAPY FOR INSOMNIA
COGNITIVE-BEHAVIOURAL THERAPY INSOMNIA (CBT-I) IS A STRUCTURED, EVIDENCE-BASED APPROACH FOR TREATING INSOMNIA.
A course of CBT-I typically lasts 6-8 weekly sessions, although this may differ according to the nature of your problems.
In this evidence-based approach, you will learn how certain patterns of thoughts and behaviour lead to difficulties falling and staying asleep. We will then work with you to break these habits and restore your natural sleep cycle.
CORE COMPONENTS
STIMULUS CONTROL
A common contributor to poor sleep quality is spending a lot of time on activities other than sleeping (e.g. reading, watching TV) while in bed. Over time, these habits reinforce the association between wakefulness and the bedroom environment, making it more difficult for you to fall asleep and stay asleep.
If you have insomnia, you may also stay awake tossing and turning in bed and this habit also contributes to the maintenance of the problem. “Stimulus control” is the practice of breaking these habits so that your body and mind learn to re-associate the bedroom with peaceful sleep.
SLEEP RESTRICTION/CONSOLIDATION
People suffering from insomnia often spend extra time in bed to try and “catch up” on the sleep they are losing. Ironically, doing this may perpetuate rather than solve the problem, as well as lead to frustration when sleep does not come easily.
As part of CBT-I, you may work with your therapist to create a more reasonable schedule for being in bed so as to optimize your sleeping time.
COGNITIVE RESTRUCTURING
People with insomnia often have unhelpful or inaccurate thoughts about their sleep, which can then cause emotions or behaviours that make sleep more difficult. For instance, they may believe that getting insufficient sleep will have immediate disastrous consequences for their health, or that “trying harder” to sleep will solve the problem.
Cognitive restructuring is a process where we will work with you to get a more balanced and objective view of these thoughts. We will teach you how to identify unhelpful thoughts and the consequences of having them, and then work with you to analyze and replace them with rational alternatives. You will be given homework so you can practice these skills between sessions.
SLEEP HYGIENE EDUCATION
Sleep hygiene encompasses various practices and habits that increase the likelihood of obtaining restorative sleep. These habits ensure that you have a good wind-down routine at the end of the day and avoid activities that would cause stress or arousal around bedtime.
RELAXATION TRAINING
If stress and anxiety are significant contributors to your insomnia problem, our therapists may teach you relaxation exercises that you can practice at home so that you can ease yourself more easily into sleep at bedtime or if you wake up in the middle of the night.