Healthy Sleep

How CBT Can Be Used To Improve Sleep

Sleeping is our body's best method of restoring itself, which is as integral as breathing. The thing about sleep is that its restorative process is highly dependent on the quality of sleep you get.

Individuals suffering from sleep disorders or those who have difficulty going to sleep in general often look into different methods to improve their sleep quality.

In this article, we look at how CBT or Cognitive Behavioural Therapy compares with other established methods to make you sleep better.

The root of sleeping problems - Insomnia

Insomnia or the inability of a person to fall asleep is the most common sleeping disorder experienced by adults. Manifesting in different degrees, Chronic Insomnia may last for a few days, and with some people - lasting for months.

Different triggers usually cause sleeping disorders - for example, mental, physical, or emotional stress.

One of the other causes of Insomnia is a general lack of good sleeping habits, poor allocation of daytime/nighttime schedules, or having too many activities before bedtime.

How is Chronic Insomnia usually managed?

Traditionally, doctors would prescribe therapeutic drugs for patients who have Insomnia. An approach involving sleep medication is only usually preferred as a short-term treatment plan.

Physicians are more conservative in prescribing sleeping pills to avoid the risk of patient abuse and dependency.

Generally speaking, while sleep medication is very useful in addressing the inability to sleep, it does not resolve the root cause of a patient's Insomnia.

What is Cognitive Behavioural Therapy for Insomnia (CBT-I)?

Cognitive-behavioural therapy for Insomnia is an established method of addressing the underlying causes of your inability to sleep.

People living with Insomnia typically have developed habits and patterns during their waking hours that inevitably affect their ability to fall asleep.

CBT-I aims to reconfigure your behaviour during your waking hours for you to experience better sleep at night.

The general idea is that good sleep habits translate into good sleep quality - when changes in practices occur, sleeping becomes much more manageable.

CBT-I as the first line of defence

Practitioners in the medical field tend to be conservative in their approach to treating and managing sleep problems.

While a route involving the intake of sleep medicine or sleeping pills and aides, insomniacs cannot correct their sleep patterns without having to depend on their medication.

CBT-I is designed for a chronic insomniac to modify daytime habits as first-line treatment for sleep deprivation.

Sleep specialists would usually assess the sleep patterns, whether through a series of conversations, a sleep diary, or in some cases, having the patient spend nights inside a sleep laboratory.

The conversations between sleep specialists and patients involve an assessment of daytime activities, sleep onset, and the overall feeling they get from poor sleep quality.

How does Cognitive Behavioural Therapy for Insomnia work?

After an assessment from your sleep specialist, a series of CBT-I techniques such as the following are recommended:

Stimulus Control Therapy

Also called stimulus control instructions, the CBT-I method looks into the sleeping habits and pinpointing the practices that prohibit a patient from having good, healthy sleep.

It adjusts your behaviour to react to the bedroom as a stimulus for sleep. Meaning, you are to avoid the bedroom for times of the day that you do not intend to sleep.

The deprivation of a bedroom forces the brain to associate the presence of a bed as a stimulus exclusive to sleeping.

Sleep Restriction Therapy

The idea of sleep restriction is to restrict the amount of time you spend in bed to be close to your total sleep time.

Many people living with chronic Insomnia tend to spend a lot of waking hours in bed before falling asleep. With sleep restriction, an insomniac is only permitted to be in bed when they are in full awareness that they can fall asleep anytime.

Doing so will align your headspace into thinking less of how to fall asleep, and allows you to do so when you are in bed.

Relaxation Training

A simple form of cognitive therapy is something that almost everybody can do. Relaxation training is as straightforward as it sounds; you train your body to calm down and generally feel relaxed.

Typical relaxation techniques involve muscle relaxation, alleviating muscle tension, breathing exercises, meditation, and quiet times.

Although it sounds simplistic, relaxation training has shown clinically significant results as a method of insomnia treatment.

Sleep Hygiene

Sleep hygiene factors in essential lifestyle habits that inhibit a person from getting better sleep quality. Sleep hygiene may involve the reduction of caffeine intake during the daytime, especially when close to your sleeping hours.

Likewise, a healthy amount of exercise is recommended for individuals during the daytime to improve sleep hygiene. Though a moderate amount of alcohol can help individuals fall asleep, it is not suitable for a night of quality sleep. Alcohol has side effects that disrupt your normal circadian rhythm instead of improving your sleep quality.

Not only is sleep hygiene an effective cognitive-behavioural therapy, but it also promotes good personal health care.

Biofeedback

As the name describes, factoring in your physiological markers is a good way for you to analyse how you sleep and adjust behaviours accordingly.

The most common metric for biofeedback is the measurement of your heart rate and muscle tension. During your sleep specialist visit, they may prescribe devices for you to take home and use as you go to sleep.

Other markers can be measured in a sleep lab environment, such as brain waves, blood pressure, and body temperature. 

For a patient with Insomnia, knowledge of these biofeedback allows you to change activities to acquire the optimal biological markers for sleep.

Improving your sleeping environment

It may sound simple, but having an environment designed with sleeping in mind has been seen as an effective treatment method for chronic Insomnia. 

Similar to stimulus training, the associations of a cool, dark, quiet environment to sleep can help the brain switch to a more relaxed mood akin to sleeping.

Final thoughts on CBT-I

Cognitive-behavioural therapy for Insomnia is an effective first-line of action for those suffering from sleep disorders. It is a clinically proven way of recalibrating your daytime habits to address sleep problems.

Likewise, CBT-I has very minimal risk as a treatment method and has no adverse side effects to the sleep-deprived patient.

If you are suffering from Insomnia or poor sleep quality, CBT-I is a highly recommended first step in resolving the causes of your sleeplessness.