The focus of this blog is to explore cognitive behavioral therapy for insomnia (CBT-I).  

Why Is This Important? 

Insomnia is a sleep disorder that is recognized globally. Insomnia is the most common sleep disorder with about 7% to 18% of adults encountering symptoms that meet the criteria for this disorder (Rossman, 2019). Forty to fifty percent of individuals encounter comorbidity of insomnia disorder and other mental disorders (APA, 2022).    

What is CBT-i? 

There are five components within CBT-I. These components include:  

1. Sleep consolidation 

1. Individuals with insomnia tend to dwell in bed with hopes of falling asleep. While doing this, a sense of worry is created that may result in the person not falling asleep, and, if the person does fall asleep, they frequently worry that they will not stay asleep while spending more time in bed.   

2. Sleep consolidation limits the time an individual stays in bed. As an individual’s sleep drive builds up, they are able to fall asleep and stay asleep easier.  

2. Stimulus control 

1.  Individuals with insomnia often associate their beds/ bedrooms with anxiety. This anxiety is a conditioned arousal due to the previous repetitive experiences where the individual could not fall asleep. 

2. If the individual cannot fall asleep within 10 minutes after turning the lights off, it is encouraged they go into another room and engage in a relaxing activity. As they start to feel more tired, they may return to bed.   

3. Cognitive restructuring 

1. Cognitive restructuring is defined as changing the negative thoughts that an individual with insomnia may experience when it comes to sleep into a constructive thought.  

2. This may look like changing the thought from “I am dreading going to bed tonight because I struggle to sleep” to “Even if it takes a little longer to fall asleep, I will be fine tomorrow.” 

4. Sleep hygiene  

1. Sleep hygiene supports the idea of having a routine before bed to promote healthy sleep.  

2. This may look like:  

1. Following bedtime and wakeup time to create a routine.  

2. Not eating close to bedtime. 

3. Avoiding alcohol before bedtime. 

4. Avoid light exposure and screen time prior to bedtime. 

5. Avoid indulging in caffeine in the afternoon or evening. 

5. Relaxation techniques  

1.  This is defined as techniques to get the body and mind to relax and prepare to sleep. This may include breathing exercises and meditation in a quiet area. 

(Rossman, 2019). 

By Sydney Kuczura, Quintessential Health Doctoral Extern 

References 

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental 

disorders (5th ed.-TR). https://doi.org/10.1176/appi.books.9780890425787  

Rossman J. (2019). Cognitive-Behavioral Therapy for Insomnia: An Effective and Underutilized Treatment for Insomnia. American journal of lifestyle medicine, 13(6), 544–547. https://doi.org/10.1177/1559827619867677