Does CBT-I work for insomnia?

Do you struggle with falling asleep at night? You may be suffering from a sleep disorder known as insomnia. However, you’re not alone, as this is one of the most common sleep disorders in the US. Various treatment plans can help you get a better night’s sleep. One particularly effective treatment method for many is CBT-I or cognitive behavioral therapy for insomnia. In this blog, we’ll dive into CBT-I and how it may be able to help with your sleep disorder.

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What is cognitive behavioral therapy (CBT)?

Cognitive behavioral therapy is a common form of psychological treatment that seeks to identify negative thought patterns or behaviors and develop skills to redirect those thoughts and behaviors in a more positive direction.

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Cognitive behavioral therapy can be used to treat a variety of conditions, such as anxiety, depression, eating disorders, insomnia and more.

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How does it work?

CBT-I is CBT specifically geared toward addressing the underlying causes of insomnia and helping an individual to develop healthy sleep habits and patterns. The negative thoughts and behaviors someone has around sleep can be identified, and the therapist and patient can work on strategies to take control of their sleep.

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During CBT-I sessions, a therapist will guide an individual through their thoughts and help to identify the factors that may be contributing to their insomnia. These factors might include stress, anxiety, lifestyle choices, thought patterns and more.

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From there, the CBT-I therapist can talk about lifestyle changes, coping mechanisms and habits that the patient can implement in their daily life to address insomnia and ultimately improve sleep quality.

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Is CBT effective for insomnia symptoms?

Studies have shown that cognitive behavioral therapy can be highly effective in treating insomnia. One of the main benefits of CBT-I is that it's a natural and long-lasting treatment method. If an individual can address insomnia with CBT-I successfully, they can avoid the side effects and dependencies of other treatment methods like medication. When it comes to sleep, medication is not a long-term solution, while CBT-I is.

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An additional benefit of CBT is that it may be able to help a patient with other underlying issues they may be dealing with. For instance, if anxiety is identified as one of the causes of insomnia, the therapist can help them work on strategies and techniques for coping with anxiety. This may help the individual with both their anxiety and insomnia symptoms, leading to a positive mental health outcome and better quality sleep overall.

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An overview of CBT-I with Dr. Omavi Bailey, MD MPH

Now that we understand a little bit more about CBT-I let’s talk a little bit about the different techniques and habits you might learn from your provider. According to Dr. Omavi Bailey, your provider will likely walk you through some of the following strategies for addressing insomnia:

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Sleep hygiene

One of the best ways to address insomnia is by improving your sleep hygiene. Sleep hygiene refers to your daily sleep habits and routines. Implementing good sleep hygiene practices can dramatically improve the quality of your sleep and your ease of falling into a deep sleep at night. Some key sleep hygiene tips to implement include:

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• Stick to a sleep schedule — You can promote better sleep by going to bed and waking up at the same time, even on weekends. This helps to set your body’s circadian rhythm.

• Avoid caffeine after a certain time — People have varying sensitivities to caffeine, but generally, you should try to avoid caffeine in the afternoon and evening.
• Avoid large meals before bed — Large meals before bed causes your digestive system to work while you try to sleep, causing sleep disruptions.

Get outside — Try to get some natural light during the day. This can help your body set its circadian rhythm and lead to better sleep.

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Relaxation techniques

Another great way to address insomnia is with relaxation techniques. These techniques can help you calm your mind and body before bed, allowing you to more easily slip into a restful sleep. There are a few different relaxation techniques that help with sleep, such as:

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• Breathing exercises — Breathing exercises can help relax your body and reduce anxiety. Your CBT-I therapist can help teach you breathing exercises, and some apps can guide you through breathing exercises at home.
• Progressive muscle relaxation — Progressive muscle relaxation is when you tense and relax different muscle groups, which helps to release physical tension and put your body in a deeper state of relaxation.
• Meditation — Meditation and mindfulness are common relaxation techniques that you can easily do anywhere. Focusing on the present moment and calming yourself can help reduce anxiety and help you fall asleep at night. Try guided meditation if you’re a beginner or are unfamiliar with meditation techniques.

Self-care — Self-care is important for helping you relax and let go of stressors. Some self-care routines before bed that aren’t overly stimulating may include a warm bath, reading a relaxing book or drinking a soothing herbal tea.

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Exercise

Exercise can also play a crucial role in improving sleep quality. It helps to tire your body out and stay asleep throughout the night. In short, engaging in regular physical activity can help to regulate sleep patterns, reduce stress and improve your overall health.

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Aim for 30 minutes of moderate-intensity exercise per day, but make sure to consult with your primary care provider before starting a new exercise program. Also, exercise doesn’t have to be a chore. As long as it gets you moving, exercising by dancing, playing basketball or whatever physical activity gets you up and engaged will help. Also, make sure to avoid exercising too close to bedtime. The increase in endorphins from exercising can make it harder to fall asleep on time.

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Stimulus control

Controlling and regulating stimuli in your environment can also help to reduce insomnia symptoms and improve sleep quality. Here are a few tips for controlling stimuli regarding bedtime:

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• Create a comfortable sleep environment — Make your bedroom a place that promotes deep sleep. This means keeping your room cool, dark and quiet. Investing in quality mattresses and pillows can also help with your sleep environment. If you have a bright room, consider investing in blackout curtains or a sleep mask to help block out light. Ear plugs or white noise can help if you live in a noisy area.
• Minimize screen time — Avoid screens before bed and try to engage in a more relaxing activity. The blue lights from the screen and engaging your brain with this type of content may make it more difficult to fall asleep. 
• The bed is for sleep and intimacy — Make sure to only use your bed for sleep and intimacy. Using your bed for reasons other than sleep and intimacy will cause your mind to associate it with these other activities.‍
• Don’t toss and turn — If you find that you’re lying in bed awake for more than 20 minutes, try to get out of bed and engage in a relaxing activity until you feel sleepier. Then return to bed and try again.

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Medications & supplements

Part of your insomnia treatment may involve medication and supplements. A health care professional may be able to provide you with prescription medications that can help with your sleep quality, if appropriate. Typically, these prescriptions would be for treating underlying conditions that contribute to your insomnia, such as anxiety or depression. However, it’s important to keep in mind that medication is not a long-term solution for insomnia and that creating better habits around sleep will help you maintain sleep quality over time.

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Your health care provider may recommend supplements to help you sleep as well. Supplements such as melatonin or certain herbal teas may help you sleep. Ask your primary care provider if they recommend any specific supplements for your insomnia.

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Sleep consult

If you’re struggling with insomnia, you may also want to consider a sleep consult. A sleep consult is when you talk to your health care provider, and they collaborate with a sleep specialist to develop a treatment plan for you.

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This sleep consult will typically involve a sleep study. Sleep studies can be conducted in person at a sleep lab, or they can be conducted remotely with an at-home sleep study. For something like insomnia, at-home studies are typically sufficient to diagnose the disorder. These studies will measure certain metrics about your sleep, which a sleep specialist can then analyze. Based on their findings, they can work with your primary care provider to develop a treatment plan uniquely tailored to your sleep issues, lifestyle and healthcare needs.

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How to get started

If you’re ready to address your insomnia, the first step is to make an appointment with your primary care provider. Along with officially diagnosing your insomnia, they will also be able to identify any other underlying conditions that may be contributing to your sleep problems. They can also help connect you with CBT-I specialists and set up a sleep study. Ultimately, your primary care provider will be your first point of contact for insomnia treatment, and they will monitor and help to adjust your treatment over time.

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Connect with a doctor or online provider

Ready to get connected with a primary care provider? For sleep disorders, you can choose to receive care from an in-person provider, or you can connect with a virtual telehealth provider if you prefer. In either case, Circle Medical is here to help.

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Book an appointment with a Circle Medical telehealth provider today!

Circle Medical is a full-stack primary care clinic that provides in-person and online care. Whatever your care preferences are, Circle Medical has you covered. If you prefer online care, you can connect with a provider today thanks to our convenient same-day appointments. Our providers can also provide you with an at-home sleep study after your initial consultation. Book your same-day appointment today to get started!