Cognitive Behavioral Therapy for Insomnia

Depressed patient is getting treatment from a psychologist

Cognitive Behavioral Therapy for Insomnia (CBT-I), is an NIH and Sleep Foundation approved method for treating insomnia without the use of sleeping pills. It includes regular visits to a clinician, often weekly, to assess and address conditions that may be contributing to insomnia or a sleep deficit. There are several different forms CBT-I can take, and a clinician will need to decide which treatment is right for each patient to try.  

Sleep Restriction Therapy

Sleep Restriction Therapy is a means of slowly conditioning the body to sleep soundly throughout the night. By delaying bedtime to very late in the night, enough sleep hormones and neurotransmitters build up in the brain, allowing the patient to sleep for longer durations and more soundly. Slowly, after a period of a week or so at a time, the clinician will advise to move bedtime to earlier and earlier, until a patient is sleeping through the whole night.

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Most patients undergoing sleep restriction therapy are advised to keep a sleep journal, so a clinician can track changes over time. A sample sleep journal is included below.

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Stimulus Control Instructions

Stimulus Control Instructions are generated by taking a comprehensive look into a patient’s sleep habits. By looking into sleep habits and routines, clinicians are able to pinpoint different actions that may be inhibiting a full night of sleep. Some common Stimulus Control Instructions are not spending time in the bedroom when not sleeping and not consuming alcohol, caffeine, and nicotine before bed.