Please welcome Dr. Anthony DiMarco, MD, Medical Director and Professor of Physiology at Case Western Reserve University
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What is CBTi and How Does it Treat Insomnia?

What is CBTi and How Does it Treat Insomnia?

Can’t sleep? You’re not alone. Nearly 70 million Americans suffer from a sleep disorder. One of the most highly recommended treatment methods is Cognitive Behavioral Therapy for Insomnia, or CBTi.

When applied to the problem of sleeplessness, CBTi focuses on developing habits and thought patterns that promote sleep. This is a clinically approved treatment method that doesn’t rely on sleeping pills.

Is it Safe?

The National Institute of Health confirms that CBTi is an effective and drug-free way to successfully treat insomnia. Randomized clinical trials have shown that the majority of patients, even those with a long history of insomnia, benefit from Cognitive Behavioral Therapy.

CBTi can be even more effective than sleeping pills and powerful medications, which usually offer only temporary relief for people dealing with insomnia. Results show that treatment with CBTi can provide long-lasting improvement in the quality and duration of sleep.

How CBTi Works

Cognitive behavioral therapy is training to modify both the mental and behavioral activities that lead to insomnia. CBTi works to replace disruptive thoughts and habits with others designed to promote healthy sleep patterns.

It’s very upsetting to be uncertain of what each night will bring. In this type of therapy, addresses the thought processes which contribute to insomnia, including worrying and racing thoughts. In many cases, the techniques taught in CBTi are also beneficial for patients in becoming more organized, focused and in control when faced with the normal stress of daily life.

Another fundamental aspect of CBTi is establishing healthy sleep behaviors. For people suffering with sleeplessness, it’s common to have an unpredictable sleep pattern. That’s why it can help to create a ‘pro-sleep’ routine which makes going to bed a positive and predictable experience. Patients who stick with the routine often find they have more success and better sleep in the long term.

For patients, this type of therapy usually requires weekly visits with a specialized doctor. Over the course of a few weeks, the clinician will run a series of assessments, set realistic goals based on the patient’s history and assign some exercises to do at home. Sessions also involve coaching the patient on techniques which help improve the capacity to fall asleep or stay asleep longer.

Methods Associated with CBTi

There are seven main methods that clinicians may implement as part of the Cognitive Behavioral Therapy for insomnia.

About CBTi Sleep Health

Sleep Hygiene Training

This type of CBTi helps fix behaviors that keep you from getting restful sleep. Sleep hygiene training is highly individualized; the doctor will need to evaluate your daily activities and provide recommendations based on your particular habits.

Common adjustments include increasing daily exercise, decreasing caffeine intake and the amount of time spent watching TV or using mobile devices. It’s important that all the recommendations are followed in order to ensure treatment success and, ultimately, to sleep better.

Stimulus Control

This method is designed to break the negative association that the patient has made with bedtime. Often, people who have been suffering from insomnia for many months or years dread going to bed. By using specialized cognitive and behavior modification techniques, these patients can develop a more positive association. Advice includes:

  • only going to bed when you are tired
  • using the bed exclusively for sleeping
  • getting out of bed if you don’t fall asleep within 20 minutes
  • and doing something relaxing, such as reading or watching TV, before returning to bed

Sleep Restriction

This strategy for resolving insomnia is designed to reset your sleep pattern. It involves initially restricting the amount of time dedicated to sleep. At first, you will feel more tired, which actually helps you to fall asleep quicker and wake up less frequently. As the quality of sleep gets better, the restriction on time spent in bed at night is gradually extended. The ultimate goal is to find the point at which you feel adequately rested. This won’t necessarily be 8 hours, as the ideal amount of sleep isn’t the same for everyone.

Relaxation training

Some people have problems sleeping because stress or anxiety cause what’s known as hyperarousal. Relaxation training is a type of CBTi that addresses this issue through instruction. It teaches people how to focus their mind in order to relieve tension and fall asleep more easily. Relaxation training employs a combination of the following techniques:

  • muscle relaxation
  • rhythmic abdominal breathing
  • meditation
  • and guided imagery

Biofeedback

This style of CBTi is sometimes used together with relaxation training. Patients are provided information about their bodies – such as blood pressure, heart rate and muscle tension – and are then trained to concentrate and lower these physiological indicators. Over the course of multiple visits, patients become more efficient at relaxing and falling asleep.

Cognitive Control

This type of therapy helps identify thoughts and feelings that are keeping you awake or waking you up during the night. A clinician or therapist can then guide you replacing negative thoughts with positive and relaxing feelings. Cognitive control often employs worry dumps or guided imagery to free your mind and rest.

Paradoxical Intention

Using reverse psychology, clinicians encourage patients to do their nighttime routine but then try to stay awake. Instead of focusing on falling asleep and worrying about the problems inhibiting it, some find relief from insomnia by doing the opposite.

Discuss your struggles with insomnia with your doctor and consult a sleep specialist to see if these methods could help improve your quality of sleep. If you’re seeking treatment for insomnia that doesn’t rely on sleeping pills, CBTi may be the best solution for you.

How Can I Get Some Sleep?

Dealing with sleeplessness can cause people to feel lonely, depressed and desperate. Sleep Health Solutions of Ohio is here to help. We are able to evaluate your sleep problems, even in the comfort of your own home.

Contact Sleep Health Solutions of Ohio to set up a consultation right away.

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