Cognitive-Behavioral Treatment for Insomnia (CBT-I)
What is Insomnia?
People with insomnia may have difficulties falling asleep, staying asleep, or they may wake up too early. They usually experience the consequences of poor sleep, such as feeling tired, feeling more easily irritated, and having trouble with concentration, relationships, and school/work performance.
What is Cognitive-Behavioral Treatment for Insomnia (CBT-I)?
CBT-I is a non-medication treatment of insomnia that is based on scientific knowledge about sleep. The goals of CBT-I are to help you fall asleep, stay asleep, and improve your daytime functioning as a result of better sleep at night. The “cognitive” part of CBT-I focuses on thoughts, feelings, and expectations about sleep and insomnia that may stand in the way of good sleep. The “behavioral” aspect of CBT-I helps people adopt personal sleep habits that, based on the science of sleep, will help them sleep better.
How long does CBT-I take?
You attend 6 sessions with a CBT-I therapist to receive a sleep-focused treatment. Each weekly session lasts approximately 60 minutes. In some cases, extra sessions may be needed and in other cases your insomnia may get better in fewer than 6 sessions. You do not need to stop other mental health therapies or sleep medications while you are in CBT-I treatment.
What happens during treatment?
Your therapist will ask you questions about your sleep and will ask you to set goals for your treatment. This will help the CBT-I therapist decide on the best course of action. You will then meet with the CBT-I therapist to:
- Learn about sleep and insomnia
- Learn ways to help improve your sleep problem
To help the treatment succeed, you need to be an active partner in solving your sleep problem. It is important that you discuss with your CBT-I therapist any problems you have with recommendations made in the course of treatment and work with the therapist to come up with solutions to these problems. Your improvement will depend upon your commitment to making changes to your every day sleep behaviors. You will be asked to monitor your sleep using a simple sleep diary each morning. The information you provide in the sleep diary is a central part of the treatment, without this information your CBT-I therapist will not be able to help you get the most benefit from the treatment.
This is a typical example of the sessions in CBTi:
Session 1: Sleep Education (info session and setting goals)
Session 2: Changing Sleep Behaviors (sleep diary & sleep hygiene)
Session 3: Changing Sleep Behaviors (Relaxation)
Session 4: Changing Thoughts about Sleep (Cognitive Therapy for Insomnia)
Session 5: Practice, Practice, and More Practice
Session 6: Summary and Relapse Prevention
Will CBT-I work for me?
Most people with insomnia benefit from CBT-I. A large body of research demonstrates that CBT-I improves sleep. Importantly, continued use of the skills you learn in CBT-I could help you sleep better long after the therapy ends. Although it is unrealistic to expect that a bad night of sleep will never happen again, the skills will learn in CBT-I will help reduce the likelihood of experiencing insomnia in the future.