Treat Insomnia Naturally with Cognitive Behavioral Therapy

Quality sleep is one of the main pillars that make up the foundation of our well-being. Sleep is one of our body’s main sources of energy, as well as the primary timeframe that our body digests stress hormones.

Unfortunately, sleep deprivation and insomnia are extremely common among the adult population. Some studies have found that as much as 50-60% of adults experience some form of insomnia. Fortunately, however, modern psychology has developed new and improved strategies to treat insomnia that are highly effective.


What qualifies as insomnia?

Insomnia is defined as difficulty falling asleep and/or staying asleep. There are several factors that can cause this. Typically, insomnia manifests as a symptom of another issue such as stress, depression, or anxiety. The occurrence of insomnia is also greatly influenced by a person’s lifestyle habits.

Because everybody requires a different amount of sleep to operate at its optimal function, insomnia is not defined by a specific set of hours that a person is able to sleep.

Insomnia is categorized as episodic, persistent, or recurrent. Episodic insomnia occurs for a period of 1-3 months at a time and is often situational. Once the primary factor contributing to the insomnia has passed, such as a stressful work project, so does the insomnia. Persistent insomnia occurs consistently for more than three months at a time. Recurrent insomnia is when two or more episodes of insomnia occur each year on a routine basis.

Sometimes, the factors that cause the onset of insomnia vary from the factors that perpetuate it. For example, someone may experience insomnia as a side effect of a medical treatment. Although the treatment is over, the insomnia may persist because of negative thought patterns the patient developed about sleep while undergoing treatment. Generally, younger people struggling with insomnia find it harder to fall asleep, while older folks find it harder to stay asleep.


Symptoms and Side-effects

Insomnia can have detrimental effects on our quality of life if left untreated. Individuals struggling with insomnia often experience lethargy, inability to focus, and irritability. This can severely damage our academic, work, and social performance, resulting in lasting negative consequences.


What is Cognitive Behavioral Therapy (CBT)?

Cognitive behavioral therapy (CBT) is a psychological treatment that is effective at alleviating a wide range of mental health issues. This form of therapy takes an individualized approach at changing unhelpful patterns of thinking and behavior that perpetuate mental and emotional distress.

Cognitive behavioral therapy for insomnia (CBT-I) has risen in popularity in recent years and is now the preferred treatment method to remedy insomnia naturally. CBT-I is shown to be effective for cases of chronic and short-term insomnia with a wide variety of causes, including PTSD, mood disorders, recurring nightmares, and chronic pain.

CBT-I typically requires 4-8 sessions of 30-60 minutes each on a weekly or biweekly basis; however, this varies from person to person. CBT-I consists of three main interventions: cognitive, behavioral, and psychoeducational.


Cognitive Interventions

Cognitive interventions are designed to transform thoughts patterns about sleep that contribute to hyperarousal around bedtime. The most common thought patterns that fall into this category are anxiety and unrealistic expectations about sleep. Changing these thoughts is often achieved through concentration techniques such as visualization. These strategies disempower negative thinking by redirecting the focus to an anchor that nurtures a restful state.


Behavioral Interventions

Behavioral interventions usually address the nighttime routine. The patient is usually equipped with a series of relaxation techniques to implement before bedtime, such as breathing exercisesprogressive muscle relaxation (PMR), and body scans that focus on sensations of heaviness and warmth.

Biofeedback is an advanced technique that may also be included. This intervention uses specialized devices to monitor the individual’s brain waves, heart rate, breathing, and body temperature. The information is then relayed back to the patient using images, sounds, or a gauge. Through consistent monitoring, patients learn how to have more control over these processes.

Stimulus control is also an important behavioral intervention. The patient must begin to associate their bed solely with sleep and sex. This often requires the removal of a TV or computer from the bedroom. Snacking, reading, and other activities are also forbidden from the bedroom. Other factors that contribute to comfort may also be taken into consideration, such as mattress quality and blackout curtains. To further reinforce this association, it is often recommended that patients get out of bed once they have spent 10 minutes lying awake and go back to bed once they are tired.

This also supports the sleep restriction method, which results in temporary sleep deprivation that increases the ability to fall asleep the following night. This method is usually included at the beginning of treatment and is not recommended for individuals with conditions that are worsened by sleep deprivation, such as epilepsy.

Sleep diaries can also be used to calculate the total time that a patient spends sleeping on any given night. Once that information is gathered, bedtime and waking time will be determined by adding 30 minutes to the average time that the patient usually spends asleep. This reduces the pressure to achieve a certain number of hours, which can contribute to the anxiety that feeds insomnia. This time frame will be gradually increased by 30 minutes as the patient successfully stays asleep during the given time frame.

Avoiding naps and going to bed at the same time every night is also a very important aspect of behavioral intervention. Other behavioral interventions include sleep hypnosis, meditation, and relaxing movement such as yoga.


Psychoeducational Interventions

Psychoeducational interventions equip the patient with information about the biological processes of sleep and how they are affected by certain thoughts, feelings, and behaviors. During this intervention, patients are also taught proper sleep hygiene. This includes a consistent morning and nightly routine that promotes quality rest, turning off all electronics within an hour of bedtime, a balanced diet, and regular exercise.

The most critical component of CBT-I is that the patient applies what they learn during their sessions to everyday life.

The risk factors of CBT-I are slim to none, although this process may unearth traumatic memories for some. However, trained professionals are fully equipped to support their patients in coping with any difficult thoughts or emotions that may arise.


Getting Help

If you are looking to improve your mental health and wellness, we are ready to help on that journey. We have a team of psychiatrists, therapists and psychologists that specialize in Cognitive Behavioral Therapy and medication management. Our team of compassionate and skilled professionals is available for in person appointments for patients in the DFW area. We also offer online appointments for patients in the Austin, DFW, Houston and San Antonio areas.


AUTHOR: Dr. Michael Messina