Psychotherapy Including Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is one type of psychotherapy. It involves meeting with a licensed professional on a regular basis in an individual or group setting. CBT works to identify and resolve psychological factors that contribute to insomnia.
For those with insomnia, CBT may be as, or more effective, than medication in short- and long-term management of insomnia. CBT may have more lasting treatment effects than medication. CBT is usually given over six weeks, with maintenance therapy given as needed.
There are specific and effective techniques that may help to reduce or eliminate anxiety and body tension. These can include meditation, visualization, and deep breathing. These techniques can help your mind to stop racing, allow your muscles to relax, and allow restful sleep. It takes some practice to learn these techniques and achieve effective relaxation.
Some people suffering from insomnia spend too much time in bed unsuccessfully trying to sleep. They may benefit from a sleep restriction program that at first allows them only to stay in bed for the number of hours the person actually sleeps, as opposed to the number of hours the person spends in bed tossing and turning. The minimum number of hours for sleep is usually about 5 hours. A person would gradually add more time in bed until a more normal night's sleep is achieved.
Another treatment that may help some people with insomnia is to recondition them to associate the bed and bedtime with sleep. For most people, this means not using their beds for any activities other than sleep and sex. As part of the reconditioning process, you are usually advised to go to bed only when sleepy. If unable to fall asleep, try getting up, staying up until sleepy, and then returning to bed. Throughout this process, you should avoid naps, and wake up and go to bed at the same time each day. Eventually your body will be conditioned to associate the bed and bedtime with sleep.
Insomnia. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/insomnia. Updated July 2017. Accessed March 7, 2018.
Insomnia. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/insomnia. Accessed March 7, 2018.
Insomnia. National Sleep Foundation website. Available at: https://sleepfoundation.org/insomnia/home. Accessed March 7, 2018.
Insomnia in adults. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114839/Insomnia-in-adults. Updated June 5, 2017. Accessed March 7, 2018.
Morin C, Vallieres A, Guay B, et al. Cognitive behavioral therapy, singly and combined with medication for persistent insomnia: a randomized controlled trial. JAMA. 2009;301(19):2005-2015.
Last reviewed March 2018 by EBSCO Medical Review Board Monica Zangwill, MD, MPH Last Updated: 3/7/2018