Cognitive Behavioral Therapy- Insomnia
CBT-I

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What is CBT-I?

CBT-I is a structured, multi-component therapy designed to help individuals who struggle with falling asleep, staying asleep, or waking up too early. Unlike sleep medications that simply mask the problem, CBT-I targets the root causes of insomnia and provides long-term solutions. Treatment typically takes six to eight sessions, either in-person or via telehealth, and can be done individually or in a group setting.

Why Does Insomnia Happen?

 

According to the Three-Factor Model of Insomnia, chronic insomnia develops due to:

• Predisposing factors – Natural traits (like high emotional sensitivity) that make some people more prone to insomnia.

• Precipitating factors – Life stressors (such as a major event or change) that trigger short-term sleep issues.

• Perpetuating factors – Habits and thoughts that keep insomnia going even after the initial trigger is gone (e.g., staying in bed longer to “catch up” on lost sleep, worrying about sleep).

CBT-I primarily targets these perpetuating factors, helping break the cycle of chronic insomnia.

 

How CBT-I Works: The Four Core Components

 

1. Sleep Restriction Therapy (SRT)

 

Many people with insomnia try to compensate for poor sleep by going to bed earlier, sleeping in, or napping—but this actually worsens sleep quality. SRT rebuilds natural sleep drive by limiting time in bed to match actual sleep duration. Over time, this strengthens the body’s ability to fall and stay asleep.

 

2. Stimulus Control Therapy (SCT)

 

For those with insomnia, the bed often becomes a place of frustration rather than relaxation. SCT retrains the brain to associate the bed with sleep, not wakefulness. The key principles include:

• Only going to bed when sleepy.

• Getting out of bed if unable to sleep within 15–20 minutes.

• Using the bed only for sleep (and intimacy).

• Maintaining a consistent wake-up time every day.

• Avoiding daytime naps.

 

3. Sleep Hygiene (SH)

Sleep hygiene includes lifestyle and environmental adjustments that promote better sleep, such as:

• Limiting caffeine and alcohol before bedtime.

• Creating a comfortable, dark, and cool sleep environment.

• Exercising regularly (but not too close to bedtime).

• Establishing a calming bedtime routine.

 

4. Cognitive Therapy (CT)

 

Negative thoughts about sleep—like “I’ll never get enough rest”—can increase anxiety and worsen insomnia. CT helps identify and replace these unhelpful sleep-related beliefs with more rational, calming thoughts. Techniques include:

• Keeping thought records to track sleep-related worries.

• Challenging and reframing catastrophic thinking.

• Practicing relaxation techniques to reduce bedtime anxiety.

 

What to Expect: Session Breakdown

 

CBT-I is a structured therapy, usually delivered in six to eight sessions:

• Session 1: Assessment of sleep concerns, medical and psychiatric history, and introduction to CBT-I.

• Sessions 2-5: Implementation of SRT, SCT, SH, and CT techniques with weekly adjustments based on sleep diaries.

• Session 6+: Refining strategies, addressing any ongoing issues, and developing a long-term sleep maintenance plan.

 

Why Choose CBT-I?

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• Proven effectiveness – Recommended as the first-line treatment for chronic insomnia.

• Drug-free solution – No reliance on medications, reducing risks of dependency or side effects.

• Long-lasting results – Helps retrain your sleep patterns for sustainable improvement.

 

Ready to Take Back Your Sleep?

You don’t have to struggle with insomnia forever. CBT-I can help you reclaim restful, restorative sleep—naturally. If you’re ready to start your journey to better sleep, contact Dr. Yoe today for a consultation.

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