Cognitive Behavioral Therapy for Insomnia: Highly Effective and Easily Accessible
By Nancy Cullen. This article was initially published in our Concussion Update newsletter; please consider subscribing.
In this New York Times article, Christina Caron discusses one of the most effective therapy treatments: Cognitive Behavioral Therapy (CBT). However, it’s not only used in clinical psychology––but also to treat a common experience: insomnia. Most people have experienced insomnia at one point in their life or another. However, for some, insomnia is a constant in their lives; one in 10 adults has chronic insomnia, and it is a common symptom after a concussion. Sleep deprivation has many negative effects on our bodies, both physically and emotionally; a lack of sleep may lengthen the healing process of a concussion, but it can also lead to anxiety and depressive symptoms. The good news is that CBT for insomnia (CBT-I) is a well-proven treatment for short and long-term insomnia and works better than medications to treat long-term insomnia––and just as well for short-term. CBT-I is also better than medications, which carry risks of side effects like memory issues, confusion, grogginess, and even falls––all of which can be quite detrimental to older people and those recovering from a concussion. See our resource on finding CBT-i sleep specialists and CBT-i apps.
CBT-I works by teaching people not only how to relax and build better sleep habits but also how to rewire the associations they have in their heads around their beds. Many people with insomnia end up fearing bedtime (‘How will I sleep tonight?’) or associating their bed with tossing and turning. The way to undo that? Only stay in bed when drowsy or actively sleeping. CBT-I says that if you’re still up after 20-30 minutes of trying to sleep, you should get out of bed and do a quiet, no-technology activity in dim lighting (such as reading – or listening to – a book with a small lamp). The main goals of CBT-I are to target and dismantle behaviors that make sleeping harder and to address and diminish anxieties surrounding sleep.
CBT-I usually works within four to eight sessions and doesn’t require a provider to get the treatment. Studies have found that self-directed online CBT-I is just as effective as having an in-person provider (which can be challenging to get in most states and possibly difficult to get insurance to cover). Getting a CBT-I treatment plan online is easy and can be either reasonably inexpensive or free; at the end of the article, Caron offers multiple online options for those interested.