If you struggle with insomnia and have difficulty sleeping you’re not alone. In a given year, about a third of adults experience symptoms of insomnia and short term problems sleeping. And up to 10% meet the criteria for insomnia disorder: difficulty sleeping at least three nights a week for a period of at least three months.
The rates of insomnia are even higher for people with mental health issues. About 90% of people with major depressive disorder report difficulty sleeping, and insomnia more than doubles the risk of developing depression. Insomnia is also a common symptom of any number of mental health issues from anxiety and PTSFD to schizophrenia and substance abuse. And insomnia isn’t only a symptom, it can contribute to other mental health issues.
Insomnia involves one or more of:
- Difficulty initiating sleep: i.e. it takes a long time to fall asleep
- Difficulty maintaining sleep: i.e. frequent awakenings or problems returning to sleep after awakenings
- Early-morning awakening with an inability to return to sleep
The Benefits of CBT for Insomnia (CBTI)
The following passage from A Managed Care Review on Insomnia: Treatment Guidelines, Emerging Therapies, and the Need for Safe, Effective Options by Julie Dopheide sums up the benefits of CBT for insomnia:
Based on robust evidence from many clinical trials, practice guidelines recommend cognitive behavioral therapy for insomnia (CBTI) as first-line treatment of chronic insomnia. The rationale is that CBTI has more durable benefit and fewer adverse effects than drug therapy.
CBTI has demonstrated efficacy for insomnia in patients with coexisting medical conditions, including chronic pain, fibromyalgia, and breast cancer, as well as in perimenopausal women with vasomotor symptoms. Efficacy has also been demonstrated for patients with coexisting psychiatric conditions, such as alcohol dependence, PTSD, and Major Depressive Disorder.
She goes on to add that:
Despite guideline recommendations and robust evidence of benefit, few patients receive CBTI. The key access barrier is the lack of trained clinicians. A recent international survey identified 752 CBTI specialists, with almost 90% located in the United States and almost 60% of them concentrated in 12 states.
I hope my brief self-help course on CBT for insomnia can help fill this gap and make CBTI more accessible. The first three videos present an overview of the CBT-I program developed by Dr. Gregg Jacobs at Harvard Medical School. For more detailed information about his online CBT-I program, please visit http://www.cbtforinsomnia.com.
The posts that follow provide additional information about modifying our thoughts with CBT, and quieting our minds by letting go of our thoughts. And if worrying is contributing to your insomnia, you’ll find a number of posts about how to reduce worrying in my Self-Help Course for Anxiety.
CBTI Self-Help Course Contents
- Positive and Negative Sleep Thoughts
- Sleep Hygiene and Sleep Efficiency
- Guided Relaxation Meditation for Sleep and Insomnia
- Thoughts Are Not Facts
- Automatic Negative Thoughts
- Cognitive Restructuring and Reframing Thoughts
- The Thought Record in CBT
- Insomnia and Letting Go of Thoughts
- Cognitive Defusion for Insomnia
- Worrying and Insomnia