How To Sleep Better with CBT?

You Need Sleep

Approximately one out of every four adults in the United States experiences insomnia symptoms annually. These episodes, typically triggered by stress or illness, tend to be transient. However, chronic insomnia, marked by the struggle to fall or stay asleep at least thrice weekly for a span surpassing three months, afflicts around one in ten adults.

Need Sleep to Shake Away Depression

The ramifications of sleep deprivation extend beyond physical health issues; they encompass mental well-being as well. For instance, a recent study conducted by the National Sleep Foundation highlighted a connection between poor sleep health and manifestations of depression.   

Furthermore, empirical studies have unveiled that inadequate sleep can trigger anxiety and emotional turmoil even in individuals who otherwise maintain good health. The good news is that a thoroughly studied and proven treatment for insomnia exists, typically necessitating no more than eight sessions: cognitive behavioral therapy for insomnia, or C.B.T.-I.

CBT and  Insomnia

In cases where accessing a provider is challenging, online resources for C.B.T.-I. are readily available. Interestingly, C.B.T.-I. is often not the initial recourse for many individuals, as suggested by Aric Prather, a sleep researcher at the University of California, San Francisco, who specializes in insomnia treatment. Instead, individuals frequently resort to sleep medications. According to a 2020 survey from the Centers for Disease Control, over 8 percent of adults reported using sleep medication on a daily or near-daily basis to aid their sleep. You can find the survey details in here 

Research Says it Works…Without the Drugs

Research has demonstrated that C.B.T.-I. is as effective in the short term as sleep medications, and even more so in the long run. Clinical trial data suggests that as many as 80 percent of individuals who undergo C.B.T.-I. experience enhanced sleep, with most patients experiencing relief within four to eight sessions, irrespective of how long they have suffered from insomnia. Philip Gehrman, the head of the Sleep, Neurobiology, and Psychopathology laboratory at the University of Pennsylvania, substantiates this assertion. 

While sleep aids like medication carry risks, especially for older individuals, who may experience issues such as falls, memory problems, or confusion due to medication usage, there are alternative approaches. C.B.T.-I., on the other hand, is considered safe for adults of all ages and can even be adapted for children. Moreover, other non-pharmacological interventions have shown promise in managing insomnia.

Try Mindfulness…So much in Your Head
Mindfulness practices, for example, have garnered attention for their potential to improve sleep quality. Techniques such as deep breathing and mindfulness meditation, integral components of cognitive behavioral therapy, have been shown to reduce anxiety and promote relaxation, aiding in better sleep.

In addition, low-frequency sound waves, often referred to as binaural beats, have been explored for their impact on sleep patterns. These sound waves, when presented at different frequencies to each ear, create an auditory illusion that influences brainwave activity. Research suggests that certain frequencies can induce relaxation and facilitate transitions into different stages of sleep.

CBD for Calm Before Bed
CBD (cannabidiol), a compound derived from the cannabis plant, has gained popularity as a potential treatment for insomnia. Some individuals have reported improved sleep after using CBD, attributing its effects to its purported calming and anxiety-reducing properties. 

Finding the Right Combination for You

Returning to C.B.T.-I., its approach is multi-faceted. While it involves strategies to address behaviors that hinder sleep, such as daytime naps or screen usage before bedtime, and replaces them with more effective habits, it also aims to tackle anxieties and negative perceptions about sleep. Frequently, insomnia fosters a sense that sleep has become "unpredictable and fragmented," states Dr. Prather. "Individuals grappling with chronic insomnia often ponder 'How will I manage to sleep tonight?'"

C.B.T.-I. imparts various relaxation techniques, like deep breathing and mindfulness meditation, and aids patients in developing realistic expectations concerning their sleep patterns. It's crucial for those with insomnia to view their bed as a place of restful slumber rather than associating it with restlessness. Individuals undergoing C.B.T.-I. are advised to leave their bed if they remain awake for about 20 to 30 minutes and engage in a quiet activity with subdued lighting, devoid of the iPhone.  Additionally, they are encouraged to remain in bed only while drowsy or asleep.  In another words, dont force it. Dr. Harris highlights that C.B.T.-I. leads to more consolidated sleep and reduced time taken to fall asleep, which proves highly advantageous for many.

Find a Provider

It's recommended to consult a healthcare professional to rule out potential physical or psychological causes before finalizing a therapist. To locate a suitable provider, one can seek out members of the Society of Behavioral Sleep Medicine or utilize resources like the Penn International CBT-I Provider Directory. A primary care physician might also offer referrals. 

However, caution is advised when using general online therapist directories, as Dr. Harris warns against individuals claiming to offer insomnia treatment without specific C.B.T.-I. Training.  Be careful with outlandish claims. Typically, the good clinics will have a long waiting list so get on the list early if you can.  

For those willing to embark on a self-directed journey, clinical trials have demonstrated that online C.B.T.-I. programs are as effective as face-to-face counseling. Various low-cost or free resources are available to teach individuals the core principles of C.B.T.-I. 

One such option is the Conquering Insomnia program, which spans five weeks and ranges in price. Insomnia Coach, a free app developed by the U.S. Department of Veterans Affairs, offers a guided training plan, sleep tracking, tips, and a sleep diary. The Sleepio app, recommended by Dr. Harris, is another reliable choice. Additionally, the A.A.S.M. and National Institutes of Health offer free online resources, including sleep diaries and guides to healthy sleep.

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