Cognitive Behavioral Therapy for Insomnia

Are you reading this at 3 a.m. because you couldn’t get to sleep? Did you wake up an hour ago and can’t quite drift off again? Is this the fourth night this week that’s happened to you?

You might just have insomnia. And cognitive behavioral therapy (CBT) for insomnia might be able to help.

Delivered by applied behavioral analysts (ABA), cognitive behavioral therapy for insomnia offers a low-risk, permanent adjustment in your sleep cycle that could off a blissful trip to dreamland.

Why Can’t I Sleep?

Insomnia is a general description for a series of disorders creating an inability to sleep in normal patterns. People with insomnia can and do sleep, but they may have difficulty getting to sleep in the first place, wake up too early, or wake up and be unable to get back to sleep quickly.

If this describes you, you’re not alone. According to a 2002 study published in the Sleep Medicine Review, insomnia may occur in up to a third of the adult population. It is concentrated in the elderly or those with mental health issues. Persistent sleep issues have been reported by between ten and fifteen percent of all adults, though.

Insomnia can come from a variety of causes, both medical and psychological. And a lack of sleep can make other medical and psychological issues worse, creating a nasty feedback loop that is hard to get out of.

Although many people turn first to over-the-counter sleeping pills, these can actually make it harder to treat the condition in the long term by further messing with your sleep cycle.

What are the 3 types of insomnia?

Even many people that struggle with getting a good night’s sleep don’t realize that there are a few different types of insomnia. Getting the proper treatment depends on the right diagnosis that correctly identifies the kind of insomnia you have:

  • Transient – Short-term insomnia, typically lasting less than a week. May be caused by stress, depression, or other medical issues that are temporary in nature.
  • Acute – Also a short-term insomnia, but lasting up to a month. Acute insomnia can result from the same causes as transient, but is more severe. Acute insomnia can result from situational stress such as problems at work or school, and is sometimes referred to as adjustment insomnia.
  • Chronic – The big daddy of insomnias, chronic insomnia lasts longer than a month and is usually associated with underlying medical or psychiatric issues. While other forms of insomnia tend to go away by themselves, chronic insomnia usually requires professional treatment.

How Can ABA Therapists Help With Insomnia?

Applied behavioral analysts are world champions at finding interventions for mental or behavioral issues without resorting to drugs. ABA is used to treat all kinds of conditions, from dementia to anxiety to attention deficit hyperactive disorder. It’s a proven therapy technique that rewires the brain for new behaviors without chemical intervention.

Many people who might otherwise turn to sleeping pills are wary of messing with their sleep cycles chemically, or may have other pharma regimes that risk bad interactions with sleeping pills.

For those folks, ABA therapists using cognitive behavioral therapy, or CBT, to treat insomnia are complete game-changer.

Interested in pursuing a career in Applied Behavior Analysis? Learn what you can do with a psychology degree with an ABA focus.

CBT For Insomnia Changes The Actions and Thoughts That Cause Insomnia

Applied behavior analysis can even work when you are asleep! Well, not exactly asleep. But CBT for insomnia treatments aren’t just something that happens in the office when you go for therapy. They are a way of adapting your thoughts, attitudes, and habits around sleep in ways to make it easier to drift off and stay zonked out all night long.

Cognitive behavioral therapy for insomnia, or CBT-I as it is often called, is actually a collection of behavioral training techniques that use operant and classical conditioning to restructure your thoughts and behaviors. Those techniques can include:

  • Sleep hygiene education – This training changes your habits around sleep, including regulating diet, getting exercise, and practicing ways to wind down mentally and physically just before bed.
  • Relaxation training – Meditation, imagery projection, playing music, and using scented candles or other calming techniques help get you relaxed and ready for sleep.
  • Stimulus control therapy – These methods are right in the ABA conditioning wheelhouse, using conditioning such as setting a consistent bedtime, using the bedroom only for sleep, and avoiding naps that confuse your sleep patterns.
  • Paradoxical intention training – Insomnia sometimes results simply from trying too hard to fall asleep, causing further stress and making it harder to get to sleep, and so on. This type of training helps you let go of worry about sleep that may be preventing sleep itself.

While any of those techniques can be used independently, and sometimes are, the collection of all of them together is what most therapists believe to be the most effective intervention.

How long does it take for CBT to work for insomnia?

CBT for insomnia takes time to be effective. Estimates range between four and ten weeks of therapy, but the reality is that every patient responds differently to the therapy.

How effective is cognitive behavioral therapy for insomnia?

A review published in the Psychiatric Clinics of North America Journal found that studies produced overwhelming evidence that CBT-I is an effective intervention for primary insomnia. That is insomnia that does not result from other medical issues, but CBT-I has also demonstrated some efficacy against secondary insomnia related to certain medical conditions.

The studies reveal that CBT-I is just as effective as pharmacological treatments in the short-term and more effective in the long term.

What is the main side effect of cognitive behavioral therapy for insomnia?

The main side effect of cognitive behavioral therapy for insomnia is a good night’s sleep! That is to say, there are no side effects, only the main effect of helping you get those Zs you deserve. Because CBT-I is a form of talk therapy, you don’t have to worry about drug side effects or negative interactions.