Sleep challenges can affect our well being in so many ways, and make other issues more difficult to tackle. Traditional ‘sleep hygiene’ advice can sometimes backfire when sleep challenges have gotten stuck in the vicious cycle of insomnia. Your therapist can provide proven strategies to help break this cycle.
Insomnia is a common sleep disorder that can make it hard to fall asleep or stay asleep. It also can cause you to wake up too early and not be able to get back to sleep. You may still feel tired when you wake up. Insomnia can drain your energy level and affect your mood. It also can affect your health, work performance and quality of life.
How much sleep is enough varies from person to person.
At some point, many adults have short-term insomnia. This can last for days or weeks. Short-term insomnia is usually due to stress or a distressing event. But some people have long-term insomnia, also called chronic insomnia. This lasts for three months or more.
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Cognitive Behavioral Therapy for Insomnia (CBT-I) is a highly effective, evidence-based treatment for chronic insomnia. It focuses on identifying and changing thoughts and behaviors that contribute to sleep problems. CBT-I aims to address the underlying causes of insomnia, leading to long-term improvements in sleep.
Treatment includes:
Effectiveness of CBT-I:
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Most people try sleep hygiene, but for chronic insomnia, sleep hygiene is not enough. Insomnia is often maintained by conditioned arousal, which means your brain has learned to be awake in bed. CBT-I addresses the underlying biological and psychological mechanisms that keep you awake, rather than just providing a checklist of habits.
CBT-I is a structured, short-term program specifically for sleep. It uses techniques like stimulus control and sleep compression to reset your body's sleep clock. Unlike regular therapy, it is highly data-driven and often involves using a sleep diary to track progress and adjust your schedule.
Actually, no. We focus on sleep efficiency first, which means the quality of the time you spend in bed. It is better to have 6 or 7 hours of solid, continuous sleep than 8 hours of broken, restless sleep. Once your sleep is consolidated, we work on gradually extending the duration.
Yes. Sleep and mental health are a two-way street. Improving your sleep often acts as a force multiplier for your mental health. By improving the sleep cycle first, many people find they have more emotional energy to work on anxiety or depression in other therapy sessions.
Colleen Carney, PhD, Cpsych, is one of Canada’s leading experts in the psychological treatment of insomnia. Professor and Director of the Sleep and Depression Laboratory at Ryerson University in Toronto, Carney asserts that there is a strong evidence base for treating insomnia first. She notes that untreated insomnia can interfere with treatment of other co-occuring conditions. (Carney, 2009) Most of us can relate to how much more difficult everything else can feel when you haven’t had a good night’s sleep.
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