Struggling with Insomnia? CBT-I Remains the First Line Treatment to Combat Sleep Difficulties

Insomnia is a sleep disorder that affects countless individuals around the world, leading to difficulties in falling asleep, staying asleep, or waking up too early. Given the pervasive effects of sleep deprivation on daily life, cognitive performance, and overall health, finding an effective treatment for insomnia is crucial. Enter Cognitive Behavioral Therapy for Insomnia (CBT-I), widely acknowledged as the first-line treatment for this sleep disorder. In fact, a recent article in the NY Times, interviewed experts who can vouch for the long-lasting therapeutic benefits of CBT-I. Let's dive into its history, how it works, and how to find a CBT-I practitioner.

The History of CBT-I

The origins of CBT-I can be traced back to the 1970s. It emerged from the broader umbrella of cognitive behavioral therapy (CBT), a type of psychotherapy that focuses on identifying and challenging negative thought patterns and behaviors. When applied to insomnia, the treatment was tailored to address the specific cognitive and behavioral factors that perpetuate sleep disturbances.

Over the decades, numerous studies have been conducted, comparing CBT-I to other treatments, including sleeping pills. Time and again, CBT-I has not only proven effective in the short term but has also demonstrated long-lasting benefits. Its long-term efficacy is a significant advantage over sleeping pills, which may lose effectiveness over time and can have potential side effects.

Principles of CBT-I

CBT-I is a structured program that tackles both the thought patterns and behaviors contributing to insomnia. Here are its main components:

1. Sleep Education and Hygiene: Patients learn about sleep cycles and the importance of maintaining a regular sleep routine. This component emphasizes practices such as limiting caffeine intake and creating a sleep-conducive environment.

2. Sleep Restriction: This involves limiting the time spent in bed, which paradoxically can improve sleep efficiency by consolidating sleep.

3. Stimulus Control: This strategy teaches patients to associate the bed and bedroom with sleep only. For instance, if one can't sleep, they're advised to leave the room and return only when they feel sleepy.

4. Cognitive Therapy: Here, patients confront and challenge beliefs and attitudes about sleep. This could include addressing anxieties about the consequences of a bad night's sleep.

5. Relaxation Techniques: Methods like progressive muscle relaxation and deep breathing exercises help reduce anxiety and create a calm mindset conducive to sleep.

Finding a CBT-I Practitioner

For those suffering from insomnia, seeking a qualified CBT-I practitioner is a step in the right direction. Here are some tips:

1. Certification: Look for a therapist certified in CBT-I. The certification ensures that the therapist has received proper training in this specific treatment.

2. Referrals: Ask your primary care physician or a sleep specialist for a referral. They might know reputable CBT-I practitioners in your area.

3. Online Directories: Websites such as the Society of Behavioral Sleep Medicine (SBSM) offer directories of trained professionals. The U Penn website also has a link to find a CBT-I practitioner.

4. Telehealth: In our digital age, online CBT-I programs and telehealth sessions have gained popularity. This is especially useful for those living in areas without nearby CBT-I practitioners. Sleep Reset is an evidence based app that uses CBT-I.

5. Interview Potential Therapists: It's essential to feel comfortable with your therapist. Consider scheduling an initial consultation to see if they’re a good fit.

While there are various treatments for insomnia, CBT-I stands out due to its evidence-based approach and long-lasting results. If you or someone you know is struggling with sleep, considering CBT-I as a first line of treatment may pave the way to restful nights and brighter days.

Greg Roussett NP, Ph.D. is a doctoral prepared, board certified psychiatric mental health nurse practitioner offering treatment for insomnia. He is certified as a cognitive behavioral therapist for insomnia (CBT-I) and is a psychopharmacologist (prescribing practices similar to a psychiatrist ), and offers both CBT-I and medication management when clinically indicated. His office is located in Rockridge in Oakland, CA and provides services across the bay area to those residing in cities inclusive of Piedmont, Lafayette, Walnut Creek, Berkeley, and San Francisco. To book a free consultation, click here.

Day Light Savings Time and Its Effects on Depression and Anxiety: Simple Strategies to Reduce Its Effects!

Daylight Saving Time (DST) is when we change our clocks by one hour twice a year. It happens in the spring when we move our clocks forward one hour and in the fall when we move them back one hour. It is intended to help save energy and make better use of daylight hours. However, DST can have an impact on our mood and health. When we change our clocks, our internal clock or circadian rhythm can get disrupted. Our circadian rhythm is what helps regulate our sleep, mood, and energy levels. When our internal clock is disrupted, it can lead to feelings of tiredness and irritation. Some studies have also found that DST can lead to an increase in depression and anxiety. In addition, there can be an increase in workplace accidents due to a decline in cognitive function and alertness. In fact, the American Academy of Sleep Medicine has come out with a statement to End Daylight Savings Time. However rest assured there are changes you can make in order to reduce the associated concerns. In this blog we will explore ways to reduce the effects of Day Light Savings Time.

Practical Tips to Mitigate the Effects of Daylight Savings Time

There are several things we can do to help mitigate the negative effects of Daylight Savings Time:

1. Gradual Adjustment

It is recommended that we gradually adjust our sleep and wake times leading up to the time change. This can be done by moving our sleep and wake times forward or backward by 15-30 minutes each day, depending on whether the time is moving forward or backward.

2. Light Exposure

Light exposure can help regulate our circadian rhythm. During the spring, Daylight Savings Time transition, exposure to bright light in the morning can help reset our internal clock and promote alertness. In the fall DST transition, exposure to light in the evening can help promote relaxation and encourage the body to wind down for sleep.

3. Exercise

Regular exercise can help improve mood, reduce stress, and promote healthy sleep. Exercise can help regulate our internal clock and promote healthy sleep patterns. However, it is important to avoid intense exercise close to bedtime as it can interfere with sleep.

4. Healthy Sleep Habits

Establishing healthy sleep habits is important for mitigating the effects of Daylight Savings Time. This includes establishing a regular sleep schedule, avoiding caffeine and alcohol close to bedtime, and creating a relaxing sleep environment.

5. Avoid Technology before Bed

Electronic devices such as smartphones, tablets, and computers emit blue light which can interfere with our production of melatonin, a hormone that regulates sleep. To promote healthy sleep, it is recommended to avoid technology for at least an hour before bedtime.

Daylight Savings Time can have an impact on our mood and health, but there are practical things we can do to help mitigate the negative effects. Gradual adjustment, light exposure, exercise, healthy sleep habits, and avoiding technology before bed can all help promote healthy sleep, improve mood, and reduce the negative effects of Daylight Savings Time. By taking these steps, we can make the transition to Daylight Savings Time easier and maintain our health and well-being.

Greg Roussett is a board certified psychiatric mental health nurse practitioner offering treatment for anxiety and insomnia. He is a cognitive behavioral therapist, psychopharmacologist (prescribing practices similar to a psychiatrist ), and offers a combination of psychotherapy and medication management to individuals experiencing depression. His office is located in Rockridge in Oakland, CA and provides services across the bay area to those residing in cities inclusive of Piedmont, Lafayette, Walnut Creek, Berkeley, and San Francisco. One of his primary specialties is working with those looking for help with depression, anxiety, and sleep disturbances. Book a complimentary consultation today here.