What is CBT-I? (written by a real life sleep psychologist)
In order to get better at most things, we can try harder, make some adjustments, exert some solid effort, and it actually works! We are better at that thing!
Unfortunately, this approach does NOT work with sleep. In fact, this strategy not only fails, but tends to make sleep problems even worse over time.
Fortunately, decades of sleep research has shown us that there IS a way to improve sleep by combining what we know about sleep biology and a bit of behavioural psychology. It’s called Cognitive Behavioural Therapy for Insomnia, or CBT-I.
In CBT-I, clients are guided through a custom sleep protocol that is developed through incorporation of their own sleep data as well as the biological basis of our sleep system.
CBT-I has 2 main phases:
Phase 1: Data collection and education
in this phase, you will complete 2 weeks of sleep logs - these need to be subjective (i.e., not your Apple watch data)
you and your therapist will review the data, looking at where you are having trouble with sleep
Your will learn the 3 main systems in our body that govern sleep (the homeostatic system that maintains balance, the circadian system that determines timing, and a psychological process that can help or hinder your sleep) so that you have a solid understanding of why you will be making specific changes
you will get a sleep schedule (based on your data and life) and the CBT-I “rules” to follow
Phase 2: Experimentation and cognitive strategies
For 2 weeks you give the instructions a try and continue collecting the data
For 2-3 sessions we review the data and problem solve any ongoing sleep issues (e.g., waking in the night for long periods or too early in the morning)
We also discuss the importance of beliefs that we hold about sleep that may be incorrect (e.g., everyone needs 8 hours of sleep per night), and use cognitive strategies to target anxious thinking that might perpetuate the insomnia
That’s it! In total, CBT-I requires an average of 4-6 biweekly sessions to experience significant benefit - a small investment for a lifetime of better sleep quality.
Written by Angela Lachowski, Ph.D., C. Psych
