Cognitive Behavioural Therapy – Insomnia

What is Cognitive Behavioural Therapy – Insomnia (CBT-I)?​

It is a structured program to help treat sleep disorders that helps you identify and change unhelpful thoughts and behaviours that can worsen sleep problems into more helpful thinking patterns and habits that improve your overall quality of sleep. It is widely recommended as a first-line of treatment for insomnia.

How does it work?

During the first session, an intake form will be filled in to help your therapist better understand what the specific insomnia problem is, the factors which may be contributing to it, as well as things you may have tried to overcome these sleep difficulties. You may be asked to record your sleep behaviours for about 2 weeks in order to get more accurate details of your sleep profile. With the intake and sleep record information, specific interventions will be discussed with you. These key interventions involve the following below.

What does it involve?

There are 5 key components in CBT-I. Based on your intake assessment and current needs, the most appropriate component(s) will be selected to help improve your overall sleep quality.

Cognitive Therapy

This component involves reframing unhelpful bedtime thoughts and beliefs (e.g. forcing your mind to be quiet, worrying about work) into more helpful ones which are conducive to decreasing the emotional distress around sleep.

Sleep Hygiene

Sleep Hygiene strategies include, but are not limited to, the following: A dark and quiet bedroom environment with a temperature comfortable for your sleeping, avoiding heavy meals, exercise, and caffeine intake at least 4 hours before bedtime, avoiding daytime naps when possible, and establishing a regular pre-sleep bedtime routine for about 1-hour.

Relaxation Techniques

These include Deep Breathing, Progressive Muscle Relaxation, and Guided Imagery, among others. Your therapist will be able to demonstrate and discuss the most suitable techniques to meet your needs.

Sleep restriction

This component involves adjusting your sleep and wake times in order to maximise the quality of sleep. Unproductive sleeping hours may be reduced during the initial stages, then, once minimised, your overall sleep duration will be increased based on your sleep profile.

Stimulus control guidelines

This component involves re-associating the concept of bedtime and your bed with being a time and place for rest rather than being associated with disrupted sleep, which can trigger frustration.