Cognitive Behavioral Therapy for Insomnia (CBT-I)
Cognitive Techniques: Address the beliefs, attitudes, and misconceptions (cognitive distortions) about sleep and insomnia. Patients learn to challenge and replace thoughts that cause anxiety and hinder sleep. It is a 6–8-week treatment plan to help you learn how to fall asleep faster and stay asleep longer. This is usually the first treatment option for long-term insomnia and can be very effective. It involves:
- CBT therapy to help you feel less nervous about not being able to sleep.
- Relaxation therapy teaches how to relax and fall asleep. Techniques such as progressive muscle relaxation, deep breathing, and meditation to lower anxiety and bodily tension.
- Sleep restriction therapy limits the time spent in bed to the actual sleep time, even if you aren’t able to sleep during this time. As sleep efficiency improves sleep time is increased.
- Stimulus control therapy associates the bed and bedroom with sleep and intimacy only. Instructions might include going to bed only when sleepy, getting out of bed if you can’t sleep and using the bedroom only for sleep and sex.
Other important therapeutic techniques include:
- Sleep Hygiene: Implementing habits and practices that are conducive to sleeping well. These include keeping a consistent sleep schedule, ensuring a dark and quiet sleeping environment, and avoiding caffeine or large meals before bedtime. Recommendations might include using blackout curtains, earplugs, or white noise machines. It also involves getting regular daily physical exercise, eating on a regular schedule, managing stress, and avoiding certain over the counter and prescriptions medications that can disrupt sleep.
- Biofeedback using electronic monitoring to convey information about physiological processes. Patients learn how to modify these processes for better sleep.
- Paradoxical Intention: This therapy involves asking the patient to stay awake rather than trying to fall asleep. This reduces anxiety around sleep and can paradoxically make falling asleep easier.
- Sleep Environment Optimization: The aim is to create a sleep-conducive environment that is dark, quiet, and cool.
- Chronotherapy: This involves adjusting bedtime incrementally over days to reset the internal clock. It’s often used for circadian rhythm disorders but can also be applied in certain cases of insomnia.
- Bright Light Therapy: Exposure to a bright light for a specific duration, usually in the morning, can help reset the circadian rhythm, especially in those whose internal clock is misaligned.
- Education: This encompasses understanding the physiology of sleep, the importance of routines, the effects of certain foods and beverages on sleep, and the impact of electronic devices before bedtime.
- In addition, patients with insomnia are often encouraged to maintain a sleep diary, which can be instrumental in identifying patterns and triggers. This diary, coupled with professional guidance, can significantly help tailor the most effective therapeutic approach for each individual.
When you can’t sleep contact Mercie Health and Wellness in Katy, Texas. We can help you learn sleep hygiene and get the assistance you need to overcome chronic insomnia. We take a humane and personalized approach to treating insomnia. You will always be treated with dignity and respect.
At a Glance
Dr. Sylvia Udokoro Nwakanma
- Doctor of Nursing Practice (DNP)
- Double Board Certified in Psychiatric Mental Health Nurse Practitioner (PMHNP-BC) and Family Nurse Practitioner (FNP-C)
- SAMSHA Certified Addictions Nurse Practitioner
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