Cognitive Behavioral Therapy for Insomnia

If you are one of the 40 million people in the U.S . who suffer from insomnia, you’ll probably try anything in pursuit a good night’s sleep. Luckily, there is a very effective option to treat insomnia that doesn’t require taking any sleeping medications. It’s called cognitive behavioral therapy for insomnia (CBT-I). The American College of Physicians recently stated that CBT-I should be the first line of treatment for insomnia (before medications). At Henry Ford, we have a clinical psychologist, Dr. Maren Hyde-Nolan, who specializes in this treatment.

What is cognitive behavioral therapy?

CBT-I helps you identify and change the behaviors that are getting in the way of a good night’s sleep. During a series of counseling sessions (usually six weekly or biweekly appointments), you will learn to retrain your body and mind.

What techniques will I learn during CBT-I?

Your habits can make insomnia worse over time, but the tools you learn during CBT-I can help break those habits. During the course of your treatment sessions, you will learn various techniques including:

• Keeping a sleep diary: This is helpful at the beginning of treatment to assess your condition. You will keep track of what time you go to bed, how long it takes you to fall asleep, how many hours you log and what you eat and drink in the evening. This information will help your doctor come up with the best solutions for your situation. You will be asked to continue keeping a sleep diary throughout treatment to see how you are progressing.
• Creating a sleep schedule: People with insomnia often spend too much time in bed, yet too little time sleeping. We will work with you to create a schedule that gives you a set bedtime and wake time. By limiting the amount of time you spend in bed trying to sleep, your body will learn to be more efficient when it’s time to fall asleep. 
• Improving bedtime habits: Many of the things we do around bedtime actually hinder our ability to fall asleep. You’ll be instructed on how to eliminate things from your bedtime routine that don’t promote sleep. These things may include electronics, caffeine and alcohol, having a clock on your bedside table, even reading.
• Weaning off medications: If you are taking any prescription or over-the-counter sleep aids, your doctor will work with you to slowly eliminate them .
• Addressing anxiety: When you are worried about not being able to sleep, it often makes it harder to sleep. We will give you tools to help quiet your mind and prepare you for sleep.
• Learning relaxation techniques: Using exercises that relax your body can also help calm your mind. We can teach you techniques such as progressive muscle relaxation (an exercise where you tense and then relax muscles from head to toe), deep breathing and meditation (a technique to focus your mind).

How effective is CBT for insomnia?

While the course of treatment is normally just six sessions, you will need to maintain your new habits in order to see continued improvements in your sleep. In the long run, CBT-I has been shown to be just as effective at treating insomnia as sleeping medications with more long-lasting effects.