Therapy for Insomnia
Restoring Sleep: Effective Strategies and Treatments for Insomnia
Are Insomnia Symptoms Wiping You Out?
Do you feel drained and exhausted, but still somehow struggle to sleep when your head hits the pillow? Is it becoming more and more difficult to fall asleep or stay asleep, no matter how many sheep you count? Perhaps you’ve already tried to improve sleep hygiene, like by cutting down on caffeine and making your bed a comfy haven, and are feeling frustrated by the lack of improvement in your sleep quality.
If you are frequently struggling to fall asleep or stay asleep or are waking up too early, you may have become stuck in a vicious insomnia cycle. But don’t despair! You are not alone, and there is a brief research-backed intervention available – Cognitive Behavioral Therapy for insomnia, or CBTi, which can help you get back to engaging with life on a full battery.
Bad Nights Can Turn Into Bad Days
One of the most painful aspects of insomnia is the impact on daytime quality of life. Perhaps you’ve noticed that after a particularly bad night’s sleep, it is more of a struggle to complete the important roles at work and at home that make your life work. Your motivation may take a hit, leaving you craving nothing more than to crawl back in bed and try to get another hour’s sleep. It may become more difficult to think and concentrate, leaving you with the irritating sense that you’re not performing to your full potential. You may notice impacts on mood, such as feeling more irritable, anxious, or depressed. Perhaps there’s even been a cost to the quality of your relationships.
If insomnia has been taking over your life, CBTi can help you get back in control.
What Processes Regulate Healthy Sleep?
Understanding insomnia begins with understanding healthy sleep. Healthy sleep results from the balance between two different forces. One force, “sleep drive,” can be thought of as your body’s “appetite” for sleep. Sleep drive is affected by (a) genetically influenced individual needs for sleep, and (b) time since sleep. When a person has had less sleep than their body’s biological need, or when it’s been a long time since sleep, sleep drive is high. However, we’ve probably all experienced times when sleep drive was high, and we were able to power through and stay conscious – at least until that final paper was submitted or work deadline was met! Our ability to do this is explained by the second force regulating sleep – our circadian rhythms or “wake drive.” In healthy sleep, the wake drive is lowest overnight and begins building in the few hours before our alarm goes off, preparing the body for wakefulness. It continues to build over the course of the day, outcompeting the sleep drive, until it crests and begins to subside around bedtime. As this happens, a “sleep opportunity window” is created; our body is primed and ready to fall asleep when the sleep drive is stronger than the wake drive.
Long story short, healthy sleep requires: (a) sleep drive to be high, (b) wake drive to be decreasing, and (c) for these processes to be optimally aligned.
What Causes Insomnia?
We all carry some baseline level of risk to develop insomnia under the right conditions. For instance, if you are prone to worry or have a family history of sleep disorders, you are more likely to develop insomnia than someone without these risk factors. Life stressors can then add another layer of risk for insomnia on top of our predisposing risk and cause short-term sleep disruption. For example, life transitions like starting a new job, moving into a new home, or having a baby may increase anxiety and stress. Anxiety can in turn heighten our wake drive. When wake drive is high, you may find yourself lying in bed mentally alert, worrying about the future or ruminating about the past as your body tries to prepare you to respond to a threat. Fortunately, the body is excellent at maintaining its own balance and will generally return to healthy sleep all on its own, even if the stressor persists. If difficulty falling or staying asleep persists for at least 3 months though, other factors may be maintaining your symptoms.
What Maintains Insomnia Over Time?
In attempting to cope with the nasty daytime effects of insomnia, people may then make some changes to try and fix their sleep. These changes are well-intentioned and intuitive – changes we would all be likely to make under the circumstances. However, they have a nasty hidden cost: they maintain insomnia over time through unhelpful impacts on the sleep drive, the wake drive, and/or their alignment.
Some of these changes include:
Behavior changes, like spending more time in bed trying to sleep or nap, sleeping whenever possible instead of keeping a set schedule, reducing exercise or socializing, drinking more caffeine, watching the clock, etc.
Thinking changes like imagining the catastrophic outcomes that could happen if you can’t get to sleep or recover from insomnia, spending a significant amount of time worrying or ruminating, trying as hard as you can to fall asleep right now, etc.
How is Insomnia Treated?
Cognitive behavioral therapy for insomnia (CBTi) is a brief (~ 6 session) intervention and has been recommended by the American College of Physicians as the first-line treatment for insomnia. The good news? CBTi is more effective than medication options when it comes to long-term insomnia relief. It is a widely recognized intervention that has even been written about in the New York Times. It will require committing to some challenging behavior changes. However, you don’t need to go it alone! Our CBTi Providers are here to provide knowledge, hope, and support along the way and develop a customized treatment plan that will work for you. Read more about components of CBTi here.
When to consider therapy for insomnia?
If you have been struggling with your sleep, the best time to reach out for help is now. The sooner you get the support you deserve, the sooner you can get back to healthy sleep. We’re here to help.
Is it Insomnia or Something Else?
Several different sleep disorders can present similarly to insomnia and require different treatment approaches than CBTi. This is why when you seek therapy for insomnia, your initial 1- 2 meetings with a Provider will focus on a thorough assessment to rule out alternative explanations for your sleep concerns and verify that CBTi is a good fit for your needs.
How can I find a therapist for insomnia?
Foothills CBT offers in person or online therapy for college students and young adults. If you want to learn more about our practice and your treatment options, email us or call our office at 720-432-7061 to schedule a session or connect with a provider for a free, 10-minute consultation.