How does CBT for Insomnia work?

If you’re reading this post, I’m assuming you’re a savvy individual who likes to do their research before they plunge right into something new. You may have been struggling with sleep issues for some time–and may have tried a number of things–but to no avail. Then somewhere along the way you heard about this CBT-I thing and you said to yourself, “wait a second, therapy can help with sleep problems!?” If that question has been knocking around in your head, check out this post about how well CBT-I really does work.

But since I know you’re a savvy shopper, I know you also like to look under the hood before you purchase. And who wouldn’t!? You want to know what you’re getting into, after all.  Cognitive Behavioral Therapy for Insomnia is a structured treatment protocol that has two main components that have been found to make it effective: stimulus control and sleep restriction. Let me explain each of these in turn:

Stimulus Control: do you know how when you walk by the fridge in the middle of the day, and your brain begins to think “food” and then you begin salivating and dreaming of your next snack, even if you’ve just eaten and aren’t hungry? Well that’s because you’ve associated the kitchen and the fridge with eating, and those cues in your environment (cue = fridge, kitchen) tell your brain to expect food. The same is true of our beds. If we spend a lot of time in our bed doing awake things, be it reading, looking at our phones, stressing about tomorrow, arguing with our partner…our brains are going to associate our bed with those things. Stimulus control helps us to tighten up the association between our bed (and our bedroom) and sleeping.

Sleep Restriction: this one might sound a little scary, and I’ll admit it’s not a walk in the park, but it’s foundational to what makes CBT-I really work. If you haven’t already, go read my pizza dough post. With CBT-I we’re trying to tighten up your pizza dough so that it doesn’t have any holes in it. In order to do that we have to restrict your sleep window for a brief period of time (2-3 weeks). This helps us to build up your sleep pressure again. Once we’ve done this, we can then add more time to your sleep window until we reach the sweet spot of total sleep time for your body’s unique composition.  Think about it like “sleep efficiency training.”

Now to be clear, CBT-I does have other components. But these two behavioral components–stimulus control and sleep restriction–are the two that sleep researchers believe are the most vital to repairing one’s sleep. 

So, if you’re interested in learning more about whether CBT-I can help you, contact me here to set up a free 15-minute consultation call today!