Cognitive Behavioural Therapy for Insomnia

CBT-I is a structured program designed to treat insomnia, a common sleep disorder characterized by difficulty falling asleep, staying asleep, or experiencing non-restorative sleep. CBT-I is considered one of the most effective treatments for chronic insomnia and is recommended as a first-line treatment by various medical organizations, including the American Academy of Sleep Medicine. At the heart of CBT-I lies the recognition that insomnia is not just a symptom, but a complex interplay of thoughts, behaviours, and emotions surrounding sleep.

At EKC we work collaboratively with our clients in order to assess for the root causes of sleep disturbances, and possible contributors (eg. trauma, health issues).

What does CBT-I entail?

1. Cognitive therapy: This component aims to identify and change dysfunctional beliefs and attitudes about sleep. It helps individuals develop healthier sleep-related thoughts and attitudes, such as reducing anxiety about sleep or challenging unrealistic expectations about how much sleep one needs. When sleep issues have gone on for a while there might be anxiety associated with the sheer thought of going to bed/sleep, that is where cognitive therapy can be helpful.

2. Behavioural therapy: Behavioural interventions focus on modifying behaviours that contribute to insomnia. This may include implementing sleep hygiene practices (e.g., maintaining a consistent sleep schedule, creating a comfortable sleep environment, avoiding stimulants like caffeine close to bedtime), stimulus control techniques (e.g., associating the bed and bedroom only with sleep and sex, not with wakefulness or other activities), and relaxation techniques (e.g., progressive muscle relaxation, deep breathing exercises) to promote relaxation before bedtime.

3. Sleep restriction: This technique involves limiting the amount of time spent in bed to match the individual’s actual sleep duration. By initially restricting time in bed and gradually increasing it based on sleep efficiency, sleep consolidation is promoted, which can help improve sleep quality and reduce time spent awake in bed. A structured sleep journal is provided and followed in order to support with this.

4. Sleep education: As therapists, our role extends beyond imparting knowledge; it’s about fostering empowerment and resilience in our clients. Through psychoeducation, we equip individuals with a deeper understanding of sleep mechanisms and the factors that influence sleep quality, empowering them to navigate their sleep journey with newfound insight and confidence.

5. Relapse prevention: Strategies are taught to help individuals maintain improvements in sleep over the long term and prevent relapse into poor sleep habits.

CBT-I is a roadmap for sustainable change, with relapse prevention strategies woven into its fabric. By arming you with tools to navigate inevitable setbacks and maintain newfound sleep habits over the long haul, we ensure that the gains made in therapy endure beyond the confines of the consulting room.