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

Many Indians are struggling with insomnia due to various reasons, and it can have an impact on a person's overall well-being. Having quality sleep is essential to getting good rest and recharging your body, reducing the risk of developing other medical conditions. Few resources are available to help those individuals having trouble sleeping. 

Introduction to CBT-I 

Cognitive behavioural therapy for insomnia (CBT-I) is an evidence-based treatment for insomnia that improves quality and overall well-being. With no side effects, this psychotherapy addresses the underlying causes of sleeping disorders. 

How CBT-I Works? 

CBT-I helps people identify the harmful thinking patterns that keep them awake at night and helps replace them with constructive ideas and actions that encourage restful sleep.    

Individuals will be able to adjust their habits, set sleep boundaries, improve their sleep environment, and acquire relaxation techniques and coping skills to manage stress, resulting in better sleep.    

Techniques Used in CBT-I 

Techniques used in CBT-I aim to find the underlying causes and to understand the connections between your thought process and how it affects your sleep.  

Cognitive Interventions 

These techniques focus on identifying and modifying unhealthy thoughts and ideas that contribute to insomnia. A therapist will help you address these dysfunctional thoughts and challenges of not falling asleep and replace them with balanced and realistic expectations. This eventually reduces anxiety and stress, which are the major causes of insomnia.   

Behavioural Interventions 

Behavioural interventions are establishing healthy routines and habits that promote quality sleep. Some of the changes might include setting sleep limitations to match the actual sleep time, developing a bedtime routine, creating comfortable sleep areas, learning relaxation methods to calm yourself, and adopting healthier lifestyles that can reinforce the natural sleep cycle. 

Psychoeducational Components 

CBT-I is not just about recognising the symptoms and treating them, it also educates each individual about sleep hygiene. Providing them with information about challenges associated with insomnia, the importance of a regular sleep-wake schedule, a healthy diet and exercise in the role of getting quality sleep, helps individuals to take an active role in managing their insomnia. 

Relaxation Techniques 

Most people struggling with insomnia are unable to calm their minds and bodies to sleep naturally; therefore, CBT-I incorporates relaxation techniques like muscle relaxation, deep breathing exercises, meditations, or yoga that promote calmness and reduce anxiety, helping them prepare for sleep. 

Five components of CBT for insomnia 

CBT-I focuses on healthy habits and behaviours that promote good sleep to rest and recharge enough. Five major components of CBT for insomnia are 

CBT for Sleep Consolidation 

CBT helps reduce the awakeness time and enhances the natural sleep cycle, improving sleep quality. Many individuals who experience little sleep, repeat awakenings, difficulty maintaining sleep, or unable to fall asleep can find sleep consolidation helpful. The idea behind this is to create a strong connection between sleeping and bed to promote longer, more restful sleep cycles. 

CBT for Stimulus Control 

This method improves sleep-bed connection by excluding all the activities that are unhelpful in inducing sleep. Such as: 

• Using bed only for sleep. 

• Avoid heavy exercise before going to sleep. 

• Getting out of bed if unable to sleep within 20 minutes. 

• Maintaining a regular wake-up time to create a routine.  

CBT for Cognitive Restructuring 

Maintaining proper sleep hygiene can significantly improve the natural sleep cycle. Educating on incorporating healthy lifestyles and habits has several benefits. Some of the changes, like 

• Regular sleep schedule  

• Avoid caffeine, alcohol, and heavy meals before bedtime. 

• Making comfortable sleeping space. 

• Limiting screen time before going to sleep. 

CBT for Sleep Hygiene 

Maintaining proper sleep hygiene can significantly improve the natural sleep cycle. Educating on incorporating healthy lifestyles and habits has several benefits. Some of the changes, like 

• Regular sleep schedule  

• Avoid caffeine, alcohol, and heavy meals before bedtime. 

• Making comfortable sleeping space. 

• Limiting screen time before going to sleep. 

CBT for Relaxation 

The base of CBT is to trace negative thoughts and ideas about sleep and transform them into healthy ones that promote sleep. Cognitive restructuring addresses the underlying causes and equips each individual with useful coping strategies that reduce anxiety and discomfort and help to stay calm, promoting good sleep. 

Benefits of CBT-I 

Each treatment option or intervention, whether therapy or medication, provides distinctive benefits that not only encourage good sleep but also improve overall well-being. 

Effectiveness Compared to Medication 

Unlike medications like sleeping pills to improve the sleeping cycle, CBT-I doesn't have any side effects and can be personalised by your therapist or counsellor to cater to each individual's unique needs and requirements. 

Long-Term Benefits 

Every technique and strategy incorporated in CBT-I provides long-term benefits such as: 

• Establish better sleeping patterns, improving sleep quality and duration. 

• Decrease dependence on sleeping medications if an individual is consuming them. 

• Enhance daytime functioning with better focus and mood. 

• Chronic insomnia can worsen comorbid conditions, but CBT-I can help reduce their symptoms. 

• Changed behaviours and beliefs that are supportive of good sleep.  

• Equipped each individual with effective coping skills.  

Addressing Comorbidities 

Unable to sleep can be a cause of other medical conditions therefore, while addressing the insomnia symptoms, CBT-I also assesses a person's mental health conditions to avoid misdiagnosing with other illnesses. It can detect other comorbidities and provide necessary interventions. 

Who can get benefits from CBT? 

Not getting enough quality sleep can bring many discomforts in life, such as being unable to focus on daily functioning, mood swings, or constant tiredness. If you or anyone you know is struggling to have good sleep and wants to improve their daily functioning, CBT-I is the perfect choice. 

Finding a CBT-I Therapist 

Finding the best therapist to treat your insomnia can be tricky, but following a few suggestions can be helpful. Getting any therapist is not fine, but you need a professional who has experience in treating insomnia. 

Qualifications to Look For 

A few qualifications checklists are required to avail the best CBT-I therapist like: 

• Make sure that your therapist is a licensed mental health professional. This could also mean psychologists, psychiatrists, and licensed professional counsellors.  

• Be sure to check whether your therapist has received special training in CBT-I or has experience in treating insomnia with CBT-I. 

Where to Find Therapists? 

Researching on the internet about therapists and checking their reviews online or consulting your primary physician can be helpful if you are searching for a therapist to treat insomnia.  

Cadabam's Mindtalk offers CBT-I that is effective in treating insomnia, and the professionals are experienced. 

Questions to Ask 

Before pursuing treatment, you should ask a few questions to clear up any confusion and gain a better understanding of the process.  

• What training and experience do you have in treating insomnia with CBT-I? 

• Which assessment instruments do you employ to measure progress?  

• Could you elaborate on your approach to insomnia treatment?  

• What kind of coping methods do you teach patients?  

• What standards do patients in your therapy program need to meet?  

Tips for Success with CBT-I 

Treating insomnia can be challenging for many for several reasons, but following a few tips can help you understand the condition better and increase success with CBT-I. 

Consistency and Practice 

No recovery is possible without consistency and practice. These are the keys to achieving success. Practising healthy habits and lifestyles such as a regular sleep schedule, a calming bedtime routine, and a stress-free sleeping space can improve sleep quality significantly.  

Practising over time can reduce the frequency and severity of insomnia episodes and create stability and routine, bringing back your natural sleep cycle.  

Common Challenges and Solutions 

 Individuals might be reluctant and unsure about the efficacy of CBT-I. Educating yourself on the nature of CBT-I and the strategies used to manage insomnia can help you proceed.   

Sleep restriction is one of the components of CBT-I, and individuals might face trouble following this routine and can become stressed, but journaling and applying coping skills from a therapist is handy. 

 The Role of MindTalk in CBT for Insomnia 

 Cadabam's Mindtalk can provide the necessary interventions and support for those struggling with insomnia. Our therapy is designed by a team of experts who are well-trained and experienced with CBT-I. After assessing your condition, each treatment plan can be personalised with a state-of-the-art facility. Our care and services are provided in a non-judgmental environment without overwhelming you. 

FAQ 

What does cognitive behavioural therapy do for insomnia? 

CBT-I helps people identify the harmful thinking patterns that keep them awake at night and helps replace them with constructive ideas and actions that encourage restful sleep.    

What are the 5 components of CBT for insomnia? 

Five components of CBT for insomnia are  

• CBT for Sleep Consolidation 

• CBT for Stimulus Control 

• CBT for Cognitive restructuring 

• CBT for Sleep Hygiene 

• CBT for Relaxation 

What are the 5 steps of CBT? 

The five steps of CBT are  

1. Assessments and Care 

2. Identification of Negative Thought Patterns 

3. Challenging and Transforming Thoughts 

4. Behavioural Interventions 

5. Practicing  

What is the most effective therapy for insomnia? 

CBT-I has proven to be effective in treating insomnia. Since each individual displays symptoms a little differently, consulting with medical professionals to find the best therapy is essential.