[Bruno]

Lately I’ve been getting up at 3 or 4 am and not getting back to sleep. This is worse since starting completing the free course, happens almost daily now, and now I’m on a pattern of going to sleep earlier and earlier, sleeping less than four hours, and struggling to stay awake in the day. I used to not worry about how my sleep problems would affect the following day, but since starting the course, now I do worry about exactly that.

I had daytime sleepiness earlier this week–not daytime fatigue, but actually falling into a dream state in the day while sitting at my desk, just by closing my eyes a moment. Last night I had a strong sleep urge at 9 pm. I managed to stay awake until 10:30 by sitting at my computer, but that’s the same behavior that contributes to my sleep problems, which have generally been with waking up at dawn and not going back to sleep.

Are there people who cannot be helped by CBT-I?

• This topic was modified 2 years, 11 months ago by Bruno.

[Martin Reed]

There are people who cannot be helped by cognitive behavioral therapy for insomnia (CBT-I) — because there’s no “one-size-fits-all” solution for chronic insomnia. However, they would be in the minority.

CBT-I is recognized as the most effective long-term treatment for chronic insomnia and that’s probably because it tackles the thought processes and behaviors that perpetuate sleep disruption. So, the vast majority of people who implement CBT-I techniques appropriately and consistently (and for long enough) do get results.

You mentioned that you have been going to bed earlier and earlier, which implies that you might not be implementing sleep restriction correctly.

I would also add that it’s not unusual for sleep to temporarily get worse when we start implementing CBT-I techniques. The goal is better sleep for the long-term and sometimes this involves accepting some short-term sleep disruption.

You might find it helpful to work one-on-one with a CBT-I therapist so you can troubleshoot your experience appropriately.

Finally, if you regularly find yourself falling asleep during the day or experiencing intense daytime sleepiness, it might be worth getting evaluated by a doctor since this could be a symptom of another sleep disorder (for example, sleep apnea).

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