By Dr. Kristina Schwalm-Baquet, MSW, RSW
My ND and MD have now both suggested I do some CBT for Insomnia. I’ve had insomnia for years now and have mostly used sleeping pills and coffee to manage it, but the sleeping pills are causing problems and I am really dependent on them. How does CBT for Insomnia work and what do you do to help?
First of all, insomnia is awful. Sub-optimal levels of sleep can create emotional-sensitivity and mental health issues. With sleep deprivation our cortisol levels increase and provoke greater vulnerability to stress, anxiety and depression. It’s no wonder you’ve been trying to manage this with medications and caffeine. But yes, I see the problem, and it’s one that I hear pretty often from people who have tried what seems like EVERYTHING to get a decent sleep.
I love this question, because I think a lot of people wonder how psychotherapy could possibly help increase regular sleep patterns. CBT for insomnia works in two parts, we go after both behaviours and cognition (like all CBT) to gradually increase regular sleep patterns. It’s usually about a 4-5 week process and it involves creating functional sleep behaviours, addressing and reworking anxious thought patterns that provoke bodily arousal during sleep hours, and sleep restriction in order to reorder a healthy sleep cycle. And yes, I said sleep restriction. This is the part that usually sounds pretty scary and counter-intuitive for all non-sleepers. But with a small amount of sleep restriction initially we can gradually begin to reset your body’s natural sleep patterns and increase total time in bed gradually until we reach your optimal sleep routine.
For those who are not sure about or not able to take on CBT therapy, I often recommend the Insomnia Workbook. It’s a great resource and it can help guide you through the CBT process if a therapist is not available to you. If you have access to a CBT therapist who has experience with insomnia, this is likely your best bet for addressing these symptoms and coping with them once and for all.
I maintain a regular mental health blog on the darouwellness.com site, so check back in for more support for anxiety, depression, insomnia, emotional difficulties, trauma and general coping and mental wellness.
Kristina Schwalm-Bacquet is a Mental Health Therapist, Supervisor and Instructor.