We all experience that occasional night or two where we cannot sleep. We toss and turn, thoughts and worry running through our heads. This is a normal reaction to life’s stressors such as relationship issues, loss, or job stress. When sleepless nights persist for three nights per week for at least three months, this is chronic insomnia. Many people turn to over-the-counter treatments such as Benadryl or Melatonin to help with chronic insomnia. Others are prescribed sleeping medications such as Ambien or Lunesta. Sleeping medications are only meant to be used short-term although many individuals use them much longer, even years at a time! Very little is known about the effects of long-term sleep medication use. All sleep medications have side effects such as a morning “hangover” as well as dependency. Sleeping pills are only moderately effective. There is actually a significant placebo effect when someone takes a sleeping pill. Many people actually fall asleep before the medication is ever absorbed in the gastrointestinal tract. Also, sleeping medications do not actually improve sleep quality or the number of hours slept. We are supposed to wake up about 6 times per night (generally so brief we do not remember) as we move through the stages of sleep. When someone takes a sleeping pill, they are just experiencing an amnesia effect where they do not recall waking up!
Cognitive Behavioral Therapy for Insomnia, or CBT-I, is a clinically-proven treatment protocol to eliminate the use of sleeping medications and treat your insomnia. Wouldn’t it be amazing to eliminate sleeping medication and improve your sleep quality and quantity of hours in just 6 weeks? Through CBT-I, you will learn how to adjust your sleep schedule and change your beliefs about sleep in order to free yourself from sleeping medication and ultimately improve your mood through better sleep. CBT-I was developed at Harvard Medical School and is clinically proven in its’ effectiveness for 90% of patients who complete the program.
CBT-I is a 6 week program that includes five sessions (two weeks are in-between sessions 4 and 5 in order to allow for practice and retention of what has been learned). CBT-I focuses upon the negative, inaccurate thoughts about sleep, not the factors that caused the insomnia to begin with. Through CBT-I, we assist you with cognitive restructuring. Cognitions are our thoughts. Cognitive restructuring means changing our thoughts about our sleep. During the night, our negative sleep thoughts cause negative emotions which trigger our stress response and stimulate our wakefulness system, which ends up disturbing our sleep. When we experience negative sleep thoughts upon awakening, this contributes to impaired mood and daytime functioning.
Through CBT-I, we will provide sleep education and cognitive restructuring, review sleep medication tapering techniques and sleep scheduling, teach relaxation and stimulus control techniques, discuss the relaxation response, as well as sleep hygiene techniques over the course of six weeks. Studies have found that improvements are maintained or enhanced at follow-ups ranging up to one year in 90% of patients. It is important to remember that you may need more than 6 weeks to fully change years of poor sleeping habits, but starting off with the foundation of CBT-I and continuing to practice on your own, your sleep will continue to improve and eventually the techniques you learned in CBT-I will become habits. Booster sessions are always available if periods of poor sleep recur and you cannot get back on your own.
After countless sleepless nights and costs of prescription or over the counter sleeping medications, the investment of 6 weeks of CBT-I will be well-worth your time and investment. At Dr. Angela Reiter and Associates in Eastchester, NY we have two clinicians who are certified in CBT-I. Dr. Angela Reiter, PsyD and Dr. Ayesha Uddin, PhD are both ready to help treat your chronic insomnia and help you start feeling like yourself again.