Understanding CBT (Cognitive Behavioral Therapy) for Insomnia

In this video, I share insights from a podcast on cognitive behavioral therapy for insomnia, featuring Dr. Ashley Mason. We discuss the definition of insomnia, which is struggling to sleep for at least three months, three nights a week, and the importance of assessing sleep patterns through a seven-day log. I emphasize the significance of stimulus control, such as using the bed only for sleep or sex, and managing worry time earlier in the day. I also mention helpful tools like the Rest app for treating insomnia. I encourage you to consider these strategies and reflect on what you can implement to improve your sleep.

Managing Insomnia Using Cognitive Behavioral Therapy

Steps to assess and manage insomnia using Cognitive Behavioral Therapy for Insomnia (CBT-I), ensuring effective implementation and understanding for team members.

Key Steps

1. Assessing the Patient 0:40

  • Define insomnia as struggling to sleep for at least three months, three nights a week, causing discomfort.

  • Ensure insomnia is not caused by a medical condition or medication.

  • Focus on sleep quality, not just quantity.

2. Keeping a Sleep Diary 1:27

  • Use the Consensus Sleep Diary or similar tools to track sleep patterns.

  • Record sleep duration, quality, and how you feel the next day for at least 7 days.

3. Implementing CBT-I Pillars 2:35

  • Stimulus Control:

    • Use the bed only for sleep and sex.

    • Avoid other activities (e.g., homework) in bed.

    • If unable to sleep after 20 minutes, get out of bed and reset in another room.

  • Time in Bed Restriction:

    • Wake up at the same time every day, including weekends.

    • Match time spent in bed to the amount of sleep needed.

4. Cognitive Tools 4:32

  • Identify and challenge racing thoughts that may disrupt sleep.

  • Use apps or workbooks to assist in cognitive restructuring.

5. Relaxation Techniques 5:16

  • Practice mindfulness and meditation to promote relaxation before bed.

 6. Sleep Hygiene Practices 5:29

  • Maintain a cool room temperature (around 65°F).

  • Use cotton sheets and blankets.

  • Dim lights in the evening and consider orange-tinted glasses to block blue light.

  • Establish a wind-down routine (e.g., reading, skincare).

  • Avoid food and exercise 2-3 hours before bed.

7. Managing Worry Time 6:20

  • Schedule 15-30 minutes daily to address worries, preventing them from interfering with sleep.

8. Middle of the Night Strategies 6:59

  • If awake, engage in boring activities (e.g., reading a magazine) with dim light.

  • Avoid electronic devices.

9. Substance Management 7:24

  • Limit alcohol and caffeine (cut off caffeine by 11 a.m.).

  • Use melatonin cautiously, ideally 3-4 hours before sleep.

10. Tapering Off Sleep Medications 9:41

  • Work with a doctor to taper off long-term sleep medications slowly.

11. Resources 10:19

  • Recommend resources such as 'Quiet Your Mind and Go to Sleep' workbook and the Red Rest app for additional support.