Cognitive Behavioral Therapy (CBT)
A Multi-Component Treatment, typically includes:
- Stimulus control
- Sleep restriction therapy
- Cognitive therapy
- Sleep hygiene
*May or may not include – Relaxation therapies
Stimulus Control~
Reassociating the Bedroom with Sleeping & Setting the Body’s Clock
-Select a standard wake-up time
-Avoid activities other than sleep and sex in bed
-Get out of bed when unable to sleep
-Avoid napping
-Go to bed only when sleepy
» read more
Sleep Restriction Therapy~
Increasing Sleep Drive & Setting the Body’s Clock
-Complete sleep diary
-Compute average total sleep time (TST)
-Limit time in bed (TIB) to TST + 30 min
-(Helpful to not start below 5.5 hours)
-Increase TIB 30 min when sleep efficiency ? 85% and patient remains sleepy
-Decrease TIB 30 min. when sleep efficiency is < 80 %
Cognitive Therapy~
Cognitive therapy simply means correcting a few misconceptions about the nature of sleep. Here are some of the more common misconceptions people have about sleep, along with the facts.
~ When I don’t sleep at night, I must sleep during the morning or nap.
Actually, if you have a bad night or two, trying to make up for it in the day may simply make the problem worse. Continue your daily routine. Go to bed at a reasonable bedtime. Many people get into a cycle where they sleep during the day, can’t sleep at night (no wonder) and then sleep during the day again.~ If I spend enough time in bed eventually I’ll feel rested.
Wrong! Rest is fine, but it is not the same as sleep. If you really can’t sleep, then seek help.
I’ve lost the ability to sleep. No one really loses the ability to sleep. Not being able to fall asleep is due to influences that have nothing to do with the ability to sleep.~ My insomnia is due to aging. This is a common misconception.
Older people actually require the same amount of sleep as younger people (adults). However, due to inactivity, depression, medication, or illness, many older people sleep during the day. This naturally reduces the time that they sleep at night. In addition, many older people shift their biorhythm so they fall asleep earlier and get up earlier. There is nothing wrong with this per se unless the person continues to try to go to bed late. Then they may end up sleep depriving themselves. Older people usually require the same amount of sleep as when they were younger, but they may end up distributing sleep during the day and night rather than consolidating sleep at night.~ My insomnia is due to a biochemical imbalance.
When you don’t know, just use the words “chemical imbalance.” There are a hundred different reasons for insomnia. It is the job of the doctor and the patient to figure out what the root cause is and deal with it in an appropriate manner.~ I must have (7, 8 or whatever) hours of sleep.
Actually, the requirements for sleep differ greatly between individuals. Some people do fine on 5 hours a night, and some require 8 to 9 hours a night. If you get five hours, but aren’t sleepy during the day and are functioning just fine, then don’t worry about it. If you need more sleep, then arrange your sleep schedule appropriately.~ I should be able to fall asleep like…
Since sleeping habits differ between individuals, do not compare yourself to someone else. Some people are champion sleepers, and some have always had some difficulty falling asleep (often they call themselves light sleepers). You need to deal with how you are and not put yourself up to someone else’s standard.~ When I can’t sleep, I must try harder.
Lying in bed “trying hard” to sleep is usually the best way to stay awake. The idea is to relax, control your thoughts and allow yourself to fall asleep.
Sleep Hygiene ~
-Limit amount of time spent in the bedroom when awake
-Gradually wind-down your mind for the night
-Only go to bed when drowsy
-If awake in bed for more than 20 minutes, leave the room for a quiet activity
-Avoid daytime naps, especially for more than 1 hour
-Exercise regularly-No more than 6 hours before bed for vigorous activity
-No more than 4 hours before bed for mild activity-Maintain a regular schedule during the day for meals, chores, etc.
-Avoid caffeine for 6 hours before bedtime
-Avoid alcohol…-When drowsy (may cause accidents)
-With sleeping pills, some medications
-Before bed (negatively affects sleep quality)-Avoid tobacco before bed/at night
-Only use sleeping pills conservatively
» read more
