CBT I or How to cure insomnia

One of the most common reasons my clients see me is for the treatment of their insomnia, a problem in some cases that has disturbed their sleep for over twenty years.

In fact, there are several types of insomnia , which explains the importance of an assessment, including keeping a sleep diary. This gives me valuable information to identify bad habits and other factors contributing to the problem.

I use CBT-I, or cognitive behavioral therapy for insomnia, to help my patients. Research shows that it helped people spend more time in slow sleep than those treated with medication. And, six months later, the benefits were still there, while the sleeping pills had no lasting benefits. CBT-I consists of several elements:

Sleep hygiene

The first thing I do when working with someone with insomnia is to take an inventory of their sleep hygiene . I ask about the environment the person sleeps in, as well as what they do, eat, and eat before trying to sleep. It sounds obvious, but for example, I recently helped a person improve their sleep just by asking them to change their winter duvet for a summer one! Another significantly improved her sleep by switching from caffeinated coffee to decaffeinated coffee, as studies have shown that for some people, even a small cup of caffeinated coffee in the morning can disrupt their sleep that night.

Train to relax

I also teach how to relax and reduce stress through relaxation techniques , which are useful for those who have trouble falling asleep, but these techniques have also been found to be very useful for people who wake up in the middle of the night and who cannot go back to sleep.

Stimulus control

People with insomnia often unknowingly condition their body to associate the night before with the bedroom or bed. In addition, they often stimulate their minds with television, video games, or even YouTube videos. Both body and mind should be calm and ready to sleep , and a few adjustments in the client's routine and behaviors can often significantly improve sleep.

Paradoxical intention

Some people worry so much about their ability to sleep that it becomes a phobia , a kind of performance anxiety. In this case, the method of treatment is to tell them to do the exact opposite of what they did: in other words, they should instead do their best to stay awake all night, which rids them of performance anxiety. Because they already know how to stay awake!

Sleep restriction

Sleep restriction is a counterintuitive but extremely effective way to improve the quality of sleep, in my experience. Using the sleep diary and after eliminating other interfering factors, I work with the patient to monitor the time they spend in bed. I have often found that my clients with insomniacs perpetuate their problem by trying to force their bodies to sleep too much .

Cognitive-behavioral therapy and ACT therapy

Most often when people wake up in the middle of the night and can't fall asleep again, it's because they start to think about the issues, but also about things like what they're going to do at work on the day. next day or the errands they need for the weekend. CBT and ACT are therapies that help patients move away from their thoughts and emotions , as well as develop greater compassion for themselves, which improves their emotional state and helps prevent the thought mill to work all night.

Sleep can be improved

It must be admitted that for two or three weeks it may be necessary to make uncomfortable changes and the patient may feel quite tired as they adjust their sleep. But insomnia is not inevitable, and in my experience it is almost always possible to significantly improve or stop it.

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Do you suffer from insomnia?