Cognitive behavioral therapy, or CBT, is a psychological treatment that is effective for improving a wide variety of mental health disorders. If you have gone to therapy for anxiety, depression, PTSD, ADHD, eating disorders, marital problems or addiction, you may have been introduced to CBT.
You can use CBT to improve your life in other ways. Experts have found that it’s effective for treating insomnia. Insomnia can be a side effect of a mental health disorder, physical condition or medication. When your body falls into a pattern of insomnia, you can use cognitive behavioral therapy for insomnia, or CBT-I, to get better sleep.
Should you meet with a therapist for CBT-I?
CBT is a method of connecting our thoughts and behaviors. CBT-I connects our thoughts, behaviors and sleep rhythms.
Have you ever felt as though your body wanted to sleep, but your mind was keeping you awake? Do you have a bedtime routine that makes you feel relaxed, cozy and safe? Are you so busy that you work hard finishing projects and cleaning the house until bedtime?
There are many ways in which your thoughts and behaviors affect the way that you sleep. Many of them may be unconscious. You could be repeating unhealthy patterns without knowing it.
CBT-I is designed to bring awareness to the circumstances surrounding your insomnia and shift them with specific techniques that rewire your body’s messaging pathways. It is a short-term treatment that may deliver results within two to eight weeks.
If you meet with a therapist in person, be prepared to commit to a consistent schedule for about six to eight weeks. After an initial consultation, a provider will adapt their approach to your needs.
A CBT-I therapist’s strategies fall into one or more of the following categories:
• Cognitive shifts – Bringing awareness to positive or negative beliefs about sleep and reframing unhelpful thoughts
• Behavioral and physical changes – Strategies for adjusting physical elements, such as energizing activities before bed or triggers in the environment; learning relaxation techniques and better sleep habits
• Educational aspects – Connecting the dots between cognition and behavior and learning about other habits that promote healthy sleep
Homework is an essential part of treatment. Clients may be asked to keep a sleep journal, practice new bedtime habits or write down unproductive thoughts when they come up.
It’s up to the client to practice what they learn. The therapist can only provide advice and education. The client must make the cognitive shifts and change their behavior to break out of unhealthy sleep patterns and establish new ones.
Can you get CBT-I therapy through an app?
A therapist can hold you accountable for doing the work that’s necessary for assimilating what you learn from CBT-I. Apps are also helpful for tracking your patterns, remembering to practice skills and techniques and providing more education.
CBT-I coach (Free)
CBT-i Coach is a free app that is available for iOS, Google and Android devices. It’s designed to supplement online or in-person CBT-I therapy with a healthcare professional.
However, anyone can download the app and use it to improve their sleep habits. While the app is not intended to replace therapy, it will guide you toward creating positive bedtime habits and resetting your biological sleep rhythms.
The VA’s National Center for PTSD partnered with several research, education and clinical experts to make this app available to the public.
The following features can help you fall asleep more easily and stay asleep longer:
• Suggestions for enhancing your sleep environment
• Advice for developing routines that support sleep
• Wake and sleep time tracker
• Relaxation tools
• Educational resources about sleep and CBT-I
RESTORE by cobalt therapeutics
Cobalt Therapeutics provides interactive software that guides clients through CBT practices for a variety of mental health issues.RESTORE is a web-based program that provides CBT-I therapy. The program, which was launched in 2006, is only available through primary care providers, health plans and mental health professionals.
The program is delivered online through seven sessions that are designed to be completed in five weeks. Prices vary based on the membership tier that you sign up for. Some of the options include one-on-one telehealth sessions with a coach.
Some of the program’s features include:
• Downloadable educational resources
• Sleep diary
• Exercises for improved sleep
• Worksheets
• Reminder emails
The program has been tested in controlled trials and delivered marked improvements in sleep quality. It has helped more than 80 percent of participants:
• Get an extra hour of sleep, on average, each night
• Decrease awake time by up to 40 percent
• Reduce the time it takes to fall asleep by 36 percent
• Perform better during the day
SHUTi
SHUTi is an app that guides subscribers through weekly, interactive CBT-I learning sessions. Its effectiveness is supported by several studies that have been published in peer-reviewed journals.
The program may be used by itself or as a supplement to therapy. It is only available through specific healthcare providers.
When you subscribe to the program, you’ll work through six learning modules. You have access to the materials for 16 weeks and can go through the program at your own pace.
The program uses an algorithm to provide you with relevant material throughout the day, such as:
• Sleep diary reminders
• Personalized recommendations for the perfect sleep window
• Education from sleep experts
• Exercises to improve sleep dynamics
• Stories from other people who struggle with insomnia
SHUTi has helped many adults with chronic insomnia:
• Awaken less at night
• Reduce fatigue
• Fall asleep faster
Sleepio
Sleepio is a web-based sleep improvement plan that is offered through employers that sign up for the program. The company is dedicated to helping organizations provide mental health alternatives as employee benefits. Helping employees manage their mental health improves productivity and drives down healthcare costs.
If you are at least 18 years old, have insomnia symptoms, are in stable physical and mental health otherwise and have access to the internet, you may be able to benefit from this automated digital program.
A virtual sleep expert walks you through six sessions that contain completely customized content to guide you toward developing strong sleep habits. The information is based on the onboarding questions that you complete upon starting the course.
Some of its features include:
• Sleep diary
• Ten tools to help you sleep
• Expert education and resources
• Personalized techniques to retrain your sleep behaviors
Sleepio clinical trials have found that the program:
• Reduces time spent falling asleep by 54 percent
• Diminishes awake time by 62 percent
• Helps people function 45 percent better during the day
• Brings about positive results in about two to three weeks
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Final thoughts
CBT-I therapy is ideal for people who struggle with insomnia. It offers natural, evidence-based strategies for getting better sleep without medications. You can use the techniques throughout your life. You’ll work many of them into your daily routine so that getting good sleep is as easy as brushing your teeth. Online apps are designed to be used along with one-on-one therapy, but anyone can practice CBT-I techniques to get better quality rest.