Cognitive Behavioral Therapy for Insomnia (CBTI) can be split into at least five core components: 1) sleep restriction therapy, 2) sleep hygiene, 3) stimulus control, 4) cognitive restructuring, and 5) relaxation therapies.
Sleep restriction therapy has been shown to be one of the most effective components of CBTI. It isn’t about restricting your sleep so much as limiting the amount of time you are allowed to spend in bed, and it aims to drive up the brain’s appetite for sleep, and promote long bouts of unbroken sleep.
Sleep restriction works by targeting the natural buildup of adenosine in your brain. Limiting time in bed through sleep restriction means you are awake longer, and the longer you are awake, the greater the build-up of adenosine. After several nights, sleep restriction helps you build up a wonderfully healthy amount of sleepiness that allows you to fall asleep more easily, and stay asleep soundly across the night. Because sleep restriction helps with building sleep pressure, it increases your sleep efficiency, meaning that you sleep almost all the time you’re in bed even though you’re in bed for less time overall. Once your sleep has stabilized, your clinician will start to add back more time that you’re allowed in bed.
The second component of CBTI is sleep hygiene, covered in the previous episode all about sleep optimization The third component involves teaching relaxation methods, such as stretching, breathing, and meditation.
The fourth component is cognitive restructuring, which involves your clinician helping to disrupt and scientifically disprove your misbeliefs and anxieties around sleep. The fifth component is called stimulus control, which means not laying in your bed fretting and catastrophizing. Stimulus control seeks to help you gradually extinguish the bad associations you may have with your bed/bedroom.
Please note that Matt is not a medical doctor, and none of the content in this podcast should be considered medical advice in any way, shape, or form, nor prescriptive in any way.
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