What Is Sleep Therapy?

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What Is Sleep Therapy?

Not sleeping well can leave you tired, irritable, and unable to concentrate. It can affect your performance at school or work, take a toll on your relationships, and affect your health and safety.

Over 100 million people in the U.S. don’t get enough sleep, of which approximately 70 million have a sleep disorder.

Sleep therapy is a form of therapy designed to improve the quality of your sleep. It can help with sleep disorders like insomnia. It may also help with other mental and physical health conditions.

“When it comes to sleep issues, there is usually a question of origin: Is a sleep disorder causing mental health symptoms or is your mental health affecting your sleep? Some common disorders that implicate sleep include depression, anxiety, bipolar disorder, substance abuse, OCD, and PTSD,” says Sabrina Romanoff, PsyD, a professor and clinical psychologist in New York City. 

Types of Sleep Therapy

“The most commonly utilized and studied type of therapy for insomnia is cognitive behavioral therapy for insomnia (CBTi). CBTi is the gold standard of evidence-based treatment for sleep problems,” says Romanoff. 

CBTi is a form of therapy that can help you recognize and replace unhealthy sleep-related thoughts and behaviors with healthier habits and attitudes. “CBTi aims to incorporate effectual sleep habits and behaviors, and in turn minimize ineffective behaviors,” says Romanoff.

Techniques

A therapist who specializes in CBTi may use different techniques to help improve your sleep. Because sleep can be impacted by many mental health concerns, your therapist may conduct a detailed assessment to determine why your sleep is being affected and draw upon multiple techniques for treatment, says Romanoff.

Romanoff outlines some of the techniques sleep therapists may use below.

Sleep Hygiene

Improving your sleep hygiene involves building healthy sleep-related habits and routines. This means changing basic lifestyle tendencies that influence sleep, such as limiting alcohol, caffeine, and smoking, and increasing exercise. It also focuses on creating a consistent sleep-wake schedule.

Sleep Environment Optimization

Your therapist may recommend altering aspects of your sleep environment so that it is comfortable and conducive to unbroken sleep. For instance, keeping your room quiet, dark, and cool, and hiding any clocks may help.

Stimulus Control

Stimulus control involves removing cues that condition your mind to resist sleep. 

For example, you may often lie in your bed and watch entertaining shows, which can cause you to associate your bed with excitement. Stimulus control encourages you to commit to a consistent bedtime and use the bed only for sleep. Your therapist may instruct you to leave the bedroom if you are unable to sleep within 20 minutes, and return only when you feel drowsy.

Paradoxical Intention

CBTi utilizes a technique called paradoxical intention, which requires you to commit to staying awake. This works because you’re not worrying about not being able to sleep. Letting go of your resistance and anxiety can often make it easier to sleep.

What Sleep Therapy Can Help With

Sleep therapy can be helpful in the treatment of several conditions, including:

  • Sleep disorders such as insomnia, restless leg syndrome, sleep apnea, and narcolepsy.
  • Mental health conditions such as depression, anxiety, bipolar disorder, substance abuse, OCD, and PTSD.
  • Physical health conditions, as not getting enough sleep can raise your risk of developing health conditions such as diabetes, heart disease, stroke, and obesity.

Benefits of Sleep Therapy

These are some of the benefits of sleep therapy:

  • Improves awareness and understanding: Seeing a sleep therapist can help you better understand why you’re unable to sleep well. It can also make you more aware of your routine and sleep hygiene habits.
  • Targets unhelpful sleep-related thoughts: Therapy can help identify and correct unhelpful thoughts such as “Why can’t I sleep through the night like a normal person?” or “I know I’m not going to be able to sleep well tonight,” or “I need to fall asleep in the next 10 minutes to get 7 hours of sleep.”
  • Promotes healthy sleep habits: Therapy can help you develop healthy sleep-related habits and routines.
  • Treats mental health issues: Therapy can help identify and treat the mental health issues that are at the root of your inability to sleep, making it a long-term solution.
  • Reduces dependence on medication: Some people rely on medication, such as sleeping pills, to help them sleep. This is a short-term solution that doesn’t treat the cause of the problem. Therapy can help reduce your dependence on sleep medication.

Effectiveness

“CBTi is widely researched in both efficacy (clinical, laboratory settings) as well as effectiveness (real-world settings),” says Romanoff. 

A 2011 study found that CBTi improved:

  • Insomnia symptoms
  • Perceived energy levels
  • Productivity
  • Self-esteem
  • Overall well-being

A 2019 study found that a brief CBTi program helped improve sleep and mood in patients with insomnia and depression.

Things to Consider

“CBTi requires consistent application and practice. Some of the approaches of CBTi, such as paradoxical intention and stimulus control, may actually cause you to lose sleep in the short-term. However, with consistency and commitment to the work, you are likely to notice enduring outcomes,” says Romanoff.

It’s important to commit to the process and be patient. Expecting immediate results can cause you to get frustrated and give up.

How to Get Started

If you would like to start sleep therapy, look for a therapist who specializes in CBTi. You can look for one near you, or explore therapists who practice online, since sleep therapists may be limited. Discuss the costs and duration of treatment with the therapist.

Check whether this form of therapy is covered by your insurance plan and whether the therapist you have identified takes your insurance.

Before you start therapy, or at your initial visit, you can expect to fill out multiple forms and questionnaires, as sleep therapists usually employ a robust assessment process to determine the causes of your sleeplessness.

A Word From Verywell

Sleep is an essential function that is interconnected with several other mental and physical health conditions. If you’re having trouble sleeping, a specialized form of therapy known as CBTi can help improve the quality of your sleep. Getting a good night’s sleep can make a remarkable difference to your mood, productivity, and overall well-being.

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Article Sources
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  2. Pigeon WR, Funderburk JS, Cross W, Bishop TM, Crean HF. Brief CBT for insomnia delivered in primary care to patients endorsing suicidal ideation: a proof-of-concept randomized clinical trial. Transl Behav Med. 2019;9(6):1169-1177. doi:10.1093/tbm/ibz108

  3. Sleep Education. Cognitive behavioral therapy.

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