Cognitive Behavioral Therapy for Insomnia-CBT-I

Almost 60% of adults report insomnia at least two nights per week. A new generation of sleeping pills on the market have prospered due to marketing and advertising, but patients experience significant side effects from sleeping pills, increased mortality, and decreased effectiveness over time. Most significantly, the use of sleeping pills reinforces the belief that the cure for insomnia comes from external factors. Cognitive Behavioral Therapy for Insomnia (CBT-I) has been proven to be more effective than sleeping pills. If a poor sleeper relies on sleeping pills, when they discontinue the medication, their insomnia returns. This can lead to a cycle of insomnia and recurrent, long-term use of sleeping pills.

Studies have shown that CBT-I helps patients fall asleep faster than when they use a sleeping pill. Another study has shown that CBT-I is more effective in the short-term and long-term than Ambien. Use of CBT-I consistently shows that 90% of patients reduce or eliminate sleeping pills (Harvard and UMass Medical Schools). CBT-I is the preferred treatment for chronic insomnia (New England Journal of Medicine and the Lancet and by the National Institutes of Health, Consumer Reports and the American Psychological Association). CBT-I also reduces insomnia in patients with a variety of co-morbid disorders (e.g. pain, fibromyalgia, depression, PTSD, and substance abuse). CBT-I actually doubles the improvement rate of depression compared to antidepressant medication alone in depressed patients with insomnia!

So what causes insomnia? Do you lie awake in bed, frustrated and tense? Do you spend too much time in bed? Do you experience negative thoughts and beliefs about insomnia? Do you try to control sleep instead of letting it happen naturally? In most instances, the causes of insomnia are sleep thoughts (cognitions) and sleep behaviors (habits) which are learned and can be unlearned through CBT-I. For most individuals, occasional bouts of insomnia are normal responses to significant life events (e.g. family or work-related stressors, losses like death or divorce, health problems, or relationship changes). For most individuals, this type of insomnia resolves on its’ own. For others, the insomnia becomes chronic insomnia. Chronic insomnia is insomnia that occurs for a month or longer, after the precipitating event has resolved. CBT-I teaches patients to strengthen their sleep system and set the stage for sleep to occur. The combination of worry about sleep and maladaptive sleep habits can transform a brief period of insomnia into chronic insomnia. CBT-I does not focus on the initial precipitating stressful life events but, rather, on changing the thoughts and behaviors that play the main role in perpetuating insomnia.

The CBT-I program is based upon extensive research and practice Harvard Medical School and the University of Massachusetts Medical School. After an intake session to discuss background and determine appropriateness for the CBT-I protocol, the CBT-I process is a six-week program that involves five 30 to 45-minute individual treatment sessions (three weekly sessions followed by two bi-weekly sessions). A typical treatment session consists of lecture/presentation of new techniques and discussion of both newly presented material and patients’ practice of previously learned techniques.

Session 1: Sleep Education and Cognitive Restructuring for Insomnia
Session 2: Sleep Medication Withdrawal and Sleep Scheduling Techniques
Session 3: Stimulus Control Techniques
Session 4: The Relaxation Response
Session 5: Sleep Hygiene Techniques
Treatment sessions #1, #2, and #3 are weekly while sessions #4 and #5 are biweekly.

Dr. Angela Reiter, PsyD and Dr. Ayesha Uddin, PhD are both certified in CBT-I and we can help you tackle insomnia and eliminate the use of prescription sleep medications! Reach out to Dr. Angela Reiter & Associates today in Eastchester, NY. We can help you sleep better and overcome chronic insomnia. CBT-I is effective for 90% of patients who successfully complete the program!