How to Use Cognitive Behavioral Therapy for Insomnia

Ashley Mason, PhD., Licensed Clinical Psychologist and Assistant Professor of Psychiatry at UCSF, is back on the podcast this week. Ashley is an expert in Cognitive Behavioral Therapy for Insomnia (CBT-I), a structured program that helps people overcome the underlying causes of sleep problems. She’s passionate about her clinical work with small groups, and there’s clearly a demand for her services - her schedule is booked for the next 8 months.

In this interview, Ashley shares her step-by-step formula for helping her patients fix their sleep. She describes some lesser-known strategies that help re-establish restful sleep patterns, including sleep restriction, scheduled worry time, and identifying cognitive distortions. She also talks about the pitfalls people encounter when recovering from insomnia, and how to avoid them.

Please consider supporting Ashley’s work.

Here’s the outline of this interview with Ashley Mason:

[00:00:13] Book: Why We Sleep: Unlocking the Power of Sleep and Dreams, by Matthew Walker, PhD.

[00:02:15] Dr. Kirk Parsley; Podcasts: How to Get Perfect Sleep with Dr. Kirk Parsley, MD (2016), and Sleep To Win: How Navy SEALs and Other High Performers Stay on Top.

[00:03:22] Book: Quiet Your Mind and Get to Sleep: Solutions to Insomnia for Those with Depression, Anxiety or Chronic Pain, by Colleen Carney, PhD. and Rachel Manber, PhD.

[00:03:35] Dick Bootzin.

[00:05:03] Cognitive Behavior Therapy for Insomnia (CBT-I).

[00:06:43] Treatment process.

[00:09:05] 5 weekly group sessions, sleep diary.

[00:12:26] Bed is for sleep and sex only.

[00:17:17] Sleep restriction.

[00:19:03] Cognitive tools for dealing with anxiety and worry.

[00:19:32] Scheduling worry time.

[00:20:15] Book: Mind Over Mood, Second Edition: Change How You Feel by Changing the Way You Think, by Dennis Greenberger, PhD., and Christine A Padesky, PhD.

[00:20:32] How to worry effectively.

[00:22:10] Behavioral activation.

[00:23:20] Identifying disempowering thoughts.

[00:24:52] Acceptance and Commitment Therapy (ACT); Russ Harris books: The Happiness Trap and The Confidence Gap.

[00:25:44] Cognitive distortions and troublesome thoughts.

[00:38:30] Bob Newhart’s “Stop It” video.

[00:38:40] New York Times article on how to use sunglasses when traveling: Yes, Your Sleep Schedule is Making You Sick.

[00:38:45] Jet Lag Rooster; Podcast: Sleep To Win: How Navy SEALs and Other High Performers Stay on Top.

[00:40:00] Stimulus control.

[00:48:12] Cal Newport; podcast: How to Live Well in a High Tech World.

[00:50:42] Bill Lagakos on Patreon.

[00:52:00] Pitfalls people encounter when recovering from insomnia.

[00:54:33] Variations in Melatonin bottle contents; Study: Erland, Lauren AE, and Praveen K. Saxena. "Melatonin natural health products and supplements: presence of serotonin and significant variability of melatonin content." Journal of Clinical Sleep Medicine 13.02 (2017): 275-281.

[01:00:39] Wall Street Journal Article: Is It Healthy to Sleep in a Hammock?; Study: Kompotis, Konstantinos, et al. "Rocking promotes sleep in mice through rhythmic stimulation of the vestibular system." Current Biology 29.3 (2019): 392-401.

[01:02:11] Article: [The American College of Physicians] Recommends CBTI as Initial Treatment for Chronic Insomnia.

[01:02:40] Dr. Josh Turknett’s 4-quadrant model (Go to minute 21:20 for a visual of the 4-quadrant model.); Podcast: How to Win at Angry Birds: The Ancestral Paradigm for a Therapeutic Revolution. 

[01:06:20] Sleepio app.

[01:07:41] UCSF Sea Lab. Ashley’s sleep clinic and her current research. 

[01:08:16] Contact Ashley to support her work. Listen to Ashley’s previous NBT podcasts: Paleo Psychology with Ashley Mason PhD (2014) and Mindfulness and Cognitive Behavioral Strategies for Diabetes and Sleep Problems (2019).