Cognitive Behavioral Therapy For Insomnia

cognitive behavioral therapy for insomnia

Having trouble catching enough sleep every night? You are not alone. According to estimates, about 10 percent of the people in the United States suffer from chronic insomnia while more than 25 percent do not get enough sleep frequently.1

Not getting sufficient sleep can seriously damage your health. This is associated with conditions like cardiovascular disease, depression, diabetes, and obesity. So how much sleep should you get? While there is no hard and fast rule, 7–9 hours a night, on average, is considered to be ideal for an adult.


If you find it difficult to go to sleep, lie awake at night, or feel like you haven’t slept well when you get up, you can always get help.2 Your doctor may treat underlying conditions like anxiety or pain, targeting the root cause. Doctors may also prescribe medication to help you sleep. But this is only done as the last resort as it can have unfavorable side effects.

Cognitive behavioral therapy (CBT), which does not have the side effects associated with medications, has also been found to be really effective at treating insomnia. So let us take a look at how this therapy can help you deal with insomnia.


Cognitive Behavioral Therapy For Insomnia

CBT is a kind of talk therapy that looks at how your thoughts and beliefs influence your feelings and behavior. It examines your thoughts and behavior to help you identify unhelpful thoughts and challenge them so that you can learn practical ways of coping with various problems.3

In treating insomnia, CBT helps you to recognize and avoid thoughts and behaviors that negatively impact your sleep. Various studies have found that it can help you fall asleep faster and for longer and found it to be more effective than medication. It provides long-term therapeutic gains.4


It is thus, ideally, the first line of treatment recommended for insomniacs.5 CBT is also found to be effective at treating insomnia that occurs in association with conditions like chronic pain, pulmonary disease, cancer, osteoarthritis, and coronary artery disease as well.6

Techniques Used In CBT

CBT can be carried out in a group setting with other people who have trouble sleeping or it may be carried out on a one-to-one basis. Various techniques can be used during this therapy to help you sleep better:


1. Cognitive Control

This involves managing and stopping worries and thoughts that can keep you up and the following techniques are used here:

  • Sleep hygiene: This involves following beneficial practices that can help you sleep. For instance, keeping regular timings for going to bed and waking up, avoiding coffee and alcohol in the evenings, and exercising regularly can all help you get proper sleep.
  • Relaxation training: This uses techniques like meditation and muscle relaxation to handle the mental or physical stress that could be obstructing your sleep.

2. Stimulus Control Therapy

This involves conditioning yourself to go to sleep when you go to bed. For instance, you can associate the bedroom with sleep by not working or watching TV in bed. Keep specific locations for specific activities and nothing else.


3. Paradoxical Intention

This involves adapting a technique where you try to keep awake. In trying to stay awake, you take care of the worries you might have about not being able to fall asleep easily.

4. Sleep Restriction Therapy

This involves limiting the amount of time you spend in bed as against the amount of time that you actually sleep. Going to bed later and getting up earlier than usual and gradually increasing the time that you spend in bed can increase the amount of time you’re able to sleep.


5. Biofeedback

This involves using sensors connected to your body to measure factors like heart rate and muscle tension. This way, you know when you are not relaxed and are better able to relax yourself.7

What Does A CBT Session Look Like?

A CBT session may last from 30–60 minutes. You go through the sessions in an order

  1. You first work with your therapist to break down the problem into relevant components, like your thoughts, feelings, and actions.
  2. Then, you can analyze these areas to determine if they are unhelpful and to also understand how they influence each other and the effect they have on you.
  3. Finally, you work out how you can change unhelpful behaviors and thoughts.

After you figure out what you need to change, you will need to implement this in your everyday life. Follow-up sessions with your therapist will also include discussions on how well you are able to implement the changes in your daily life.

A course of treatment can take anywhere between 5 and 20 sessions. Sessions are generally scheduled once in 1 or 2 weeks.8