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Cognitive Behavioral Therapy for Insomnia

Cognitive Behavioral Therapy for Insomnia

Almost everyone can relate to a restless night of sleep and have experienced the unpleasant next day consequences. Fortunately, most people experience sleepless nights less frequently. For many individuals, a sleepless night can often be associated with a stressful period in their life and can easily be connected to why sleep was affected in the first place. Sleeping better after losing sleep for a night or two, feels refreshing and represents a return to normal sleep.

Unfortunately, individuals with insomnia have trouble sleeping almost every night. Insomnia is a common complaint, affecting between 6 to 15 percent of the population. Insomnia can be reports of unrefreshing sleep, waking before the desired wake time, difficulty falling asleep or maintaining sleep that is associated with distress and/or negatively impacts daytime functions. Patients with insomnia have daytime impairment affecting mood, work performance, and mental function. Patients report a decrease in their quality of life. Patients with insomnia also have an increased risk of obesity, diabetes mellitus, heart disease, high blood pressure, depression, anxiety, suicide and substance use.

Sleep is a natural process that should occur automatically. People who sleep well, often report never trying to sleep but simply sleeping. Individuals with insomnia will try to sleep, which disrupts the normal process. Over time, individuals with insomnia develop bad habits in order to improve their sleep. Individuals with insomnia may adopt strict sleep rules, avoid early morning obligations, or plan their life around sleep, often sacrificing previously enjoyed activities. Individuals suffering from insomnia may experience a night of good sleep but rarely understand why that night’s sleep was better. For an individual with insomnia, the process of sleep may feel like a game with unclear rules. Often times, those individuals that fall into a rigid sleep routine will find this difficult, if not impossible, to change without help.

Most commonly, individuals seeking help for insomnia are treated with sleep aides and few know of any other available treatment options. Cognitive-behavioral therapy for insomnia or CBT-I is a non-medication insomnia treatment targeting core attributes responsible for disrupting sleep which may include behaviors, emotions, and thoughts that affect the regulation of sleep. CBT-I is equally effective in comparison to sleep aides in the short-term treatment of insomnia. However, CBT-I is more effective than sleep aides in the long-term treatment of insomnia. Cognitive-behavioral therapy is recommended as the first line therapy for the treatment of insomnia by the National Institute of Health, American Academy of Sleep Medicine, and American College of Physicians. Improvements in insomnia not only improve a patient’s quality of life, daytime function, and pain but also mental health conditions such as depression and anxiety. If you are suffering from insomnia and are unable to find an effective long-term solution, you may want to consider CBT-I.

Kristy Weigum, DNP, FNP-C


(Kristi Weigum, DNP, FNP-C, specializes in Cognitive Behavioral Therapy for Insomnia (CBT-I) at CHI St. Alexius Health.)