What is Cognitive Behavioral Therapy for Insomnia (CBT-I)?

Video transcript:

If you’ve been struggling with insomnia you’ve probably heard of CBT-I otherwise known as cognitive behavioral therapy for insomnia. If not, let me tell you a bit more about it.

Cognitive behavioral therapy for insomnia (otherwise known as CBT-I) is a collection of techniques that are designed to improve sleep over the long term.

A typical course of CBT-I will include five components:

It will start with sleep education to give you a better understanding of what normal sleep actually is.

It will include sleep restriction — which is a terrible phrase because it implies that we’re restricting sleep when what we’re actually doing is restricting the amount of time you spend awake in bed so the amount of time you allot for sleep more closely represents the amount of sleep you’re getting (the end result of this technique is to associate the bed with sleep rather than wakefulness).

The third technique is stimulus control — more really awkward terminology, but basically this again is intended to associate the bed with sleep rather than wakefulness and this is achieved by making sure that the only thing you do in bed is sleep, so if you wake during the night or you’re struggling to fall asleep at the start of the night then you get out of bed until you feel sleepy then you get back into bed and you repeat the process.

CBT I will also normally include some elements of relaxation so you’ll be implementing some relaxation techniques. It may also include sleep hygiene which on its own will not typically address chronic insomnia but some of the techniques do have value and when combined with other CBT-I techniques they can be effective in improving sleep.

The final element that’s normally included in CBT is relapse prevention and this gives you a record and helps you understand the techniques that really worked for you so that in the future if sleep issues do return you can refer to this list, be aware of the techniques that worked, and implement them immediately to prevent any short-term sleep disruption becoming more of a long-term problem.

I talked about CBT-I in a bit more detail in this Facebook Live from April 2019:

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