A Better Way to Treat Insomnia

Have you been having trouble sleeping? You are certainly not alone. Estimates range that  around 20-40% of the United States population is having some degree of insomnia since the start of the COVID-19 pandemic. Times of high stress in our lives is frequently met with worse sleep, which for most of us returns to normal following the removal of the stressor. However, the pandemic has been a lingering and many-pronged stressor in all of our lives.

Sleep is such a huge part of our lives and yet so few of us truly know enough about it. For example, did you know that the idea that the ideal night of sleep is eight uninterrupted hours is a myth? Research demonstrates that humans have better health outcomes at an average of seven hours, and that it is completely normal to have a few brief awakenings throughout the night. In fact, a diagnosis of insomnia requires in part that the person either awake for an hour before falling asleep at least three nights/week or is awake for more than an hour three times per week, with daytime impairment. Also, sleep changes as we age, and it is normal for middle-aged and older adults to awaken more frequently and for longer intervals.

A big part of what creates chronic insomnia is our thoughts about sleep (e.g. “I’m not getting enough sleep, I’m not going to be able to function in the morning”) and our behaviors around sleep (e.g. anxiously watching the clock, trying to “force” sleep, spending too much time in bed, trying to compensate for less sleep with too much caffeine). Taking sleeping pills nightly can perpetuate the idea that we can’t sleep without a pill. Many of these pills foster a physical as well as psychological dependence, as well as changing the structure of our sleep and giving us unwanted side effects (such as morning sedation).

Fortunately there is a better way to get a good night’s sleep in the form of CBT-I, which stands for Cognitive Behavioral Therapy for insomnia. This treatment is designed to help the insomnia sufferer to challenge the unhealthy thoughts and behaviors that perpetuate poor sleep.  Several studies have demonstrated CBT-I’s higher effectiveness at helping people fall asleep faster and stay asleep longer than sleeping pills. Some people can do this work on their own with helpful apps and information found in books and/or online. Some people find that they need the structure of a trained therapist to help them stay consistent with changing their sleep thoughts and behaviors.

One potentially helpful app is called CBT-I Coach. It was developed by the Department of Defense and the Veteran’s Administration for service members; however, it is equally effective for civilians to use. The app is based on research evidence, is free, and does not collect and sell your data (unlike many other health apps). A useful website to start is cbtforinsomnia.com. On this site you can find a self-help manual for purchase if you wish. You can also search for CBT-i-certified therapists in your area. I am certified to treat insomnia with CBT-i.