Help For Insomnia: Tips From The CBT Playbook

By Margie Nichols, Ph.D.

Some people have insomnia because they have medical sleep disorders like sleep apnea. But for the millions whose sleeplessness is primarily driven by anxiety, stress, racing thoughts, etc. the treatment of choice is cognitive behavioral therapy. It may take two to four weeks before the techniques start to work, and many of them focus on helping people develop better ‘sleep hygiene’, or habits around sleep.

TIP NUMBER ONE: use your bed for only two things- sleep and sex. You are attempting to condition yourself so that the bed is associated with sleep. No reading or watching TV in bed. And if you try to go to sleep and can’t, after 20 minutes you get up and do something else.

TIP NUMBER TWO:  it’s a little different for people whose problem is waking up too early.  The first thing you should do if this happens is to try a relaxation exercise, visualization, or meditation.  That may allow you to fall back to sleep.  If you don’t fall asleep,remain in bed and rest quietly- this is nearly as rejuvenating as sleep.  If you are too restless for that – get up and do something.

TIP NUMBER THREE;  try to go to sleep and wake up at the same time every day, and don’t allow yourself to take naps.  If you are sleep-deprived and force yourself to stay awake, you are more likely to sleep the following night. Naps will just prolong your getting on a normal sleep-wake cycle.

TIP NUMBER FOUR:  in general, make sure distractions – and light – are minimized in your bedroom, which may mean blackout shades or heavy curtains, a sleep mask, or even ear plugs.

Not everyone is helped by these steps, but before you run to a sleep center or rely too heavily on sleep medication – try them out.


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