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How have you been sleeping?



If there is one health metric I LOVE to get nerdy about, it is sleep! I became interested in this treatment area while working in long-term care environments in which chronic Insomnia was a frequent concern. I wanted to help my clients become better sleepers so I went on a deep dive into Cognitive Behavioral Therapy for Insomnia or CBT-I. Read on if you think this therapy might be right for you.


Poor sleep is a common concern with multiple etiologies and consequences. Insomnia is a precursor for suicide, depression, and PTSD. (1) Veterans tend to experience Insomnia at a much higher rate than the general population, with as many as two-thirds meeting diagnostic criteria for Insomnia following deployment. (2) Other sleep disorders such as sleep apnea and circadian rhythm disorder may shorten the lifespan via cardiovascular and metabolic distress (3).


Insomnia is the most common sleep disorder and the one we can do the most to remedy. Insomnia impacts around half of the adults in the United States (4) and is easily treatable; unfortunately, there is a wide gap between patients in need of treatment and trained clinicians.


The current gold standard for insomnia treatment is Cognitive Behavioral Therapy for Insomnia (CBT-I). This brief intervention is a fantastic little powerhouse that yields fast and lasting results! CBT-I combines the Behavioral Model of Insomnia developed by Art Speilman in 1987 and the Stimulus Control Model pioneered by Richard Bootzin. The two primary components of the modality, stimulus control therapy (SCT) and sleep restriction therapy (SRT), reacclimate the mind and body back to healthy sleep rhythms. CBT-I also contains some traditional CBT elements, including behavioral changes, correcting cognitive distortions related to sleep, and psychoeducation. Therapy is typically supplemented with relaxation training, progressive muscle relaxation, and Imagery Rehearsal Therapy if nightmares are of concern. CBT-I is the only approved treatment for Insomnia besides hypnotic medications. The American Academy of Sleep Medicine and the American College of Physicians recommend CBT-I as the first-line treatment for Insomnia (6).


If you would like to learn more about CBT-I, I have attached several resources!


If you need more convincing that CBT-I is the coolest sleep hack you will ever learn, here are the top 5 reasons I love providing this therapy:


  1. This is an EASY treatment modality because it is time-limited and follows specific session plans.

  2. Treating Insomnia decreases symptoms of other disorders, but especially Depression, Anxiety, and PTSD!

  3. CBT-I can be provided in a group format.

  4. CBT-I can be provided as an adjunct therapy with treatment plan collaboration.

  5. CBT-I involves data collection and math, so engineers really love it! I 💓 HSV

App:

CBT-I Coach - Free App developed by the Veterans Administration


Links and References:

  1. https://www.hopkinsmedicine.org/endoscopic-weight-loss-program/conditions/obstructive_sleep_apnea.html#:~:text=Studies%20have%20shown%20that%20sleep,accidents%20due%20to%20decreased%20attention.

  2. Sleep Health. 2015 March; 1(1): 11-12. doi:10.1016/j.sheh.2014.12.011






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