Cognitive Therapy and Sleep

Cognitive behavioral therapy (CBT) helps you change actions or thoughts that hurt your ability to sleep well. It helps you develop habits that promote a healthy pattern of sleep.

Cognitive behavioral therapy has been shown to be a highly effective approach for the treatment of primary insomnia. Cognitive behavioral therapy for insomnia typically involves:

• Stimulus control (see below)
• Sleep restriction (restricting the amount of time in bed)
• Relaxation strategies (breathing and muscle relaxation to help promote sleep)
• Cognitive restructuring - (identify dysfunctional beliefs and attitudes patients may have about their sleep and replace them with more adaptive substitutes)

Stimulus control

Stimulus control is a set of instructions aimed at undoing conditioned arousal at bedtime by reassociating the bedroom with rapid sleep onset.

Typical instructions are as follows:

• Go to bed only when you are sleepy.
• If you do not fall asleep within 15 minutes or wake up and can't resume sleep within 15 minutes, leave the bedroom and return only when sleepy again. Repeat as often as necessary.
• Use the bedroom only for sleep and sex. Do not read, watch TV, work, or eat in bed.
• Get up at the same time every morning, including weekends.
• Avoid daytime napping.