Do you dread falling asleep?
I’ve struggled with insomnia, and still do from time to time.
In this article, I’ll share research based tips from an approach called cognitive behavioral therapy for insomnia (cbt-i for sleep) to help you get to sleep faster and more efficiently.
What You Need To Know About CBT-I for Sleep
1. What Is CBT-I for I Sleep?
The Mayo Clinic tells us that
Cognitive behavioral therapy for insomnia is a structured program that helps you identify and replace thoughts and behaviors that cause or worsen sleep problems with habits that promote sound sleep. Unlike sleeping pills, CBT-I helps you overcome the underlying causes of your sleep problems.
According to CBT-i Coach, the “cognitive” part of CBT-i helps you learn about your thoughts, feelings, and expectations about sleep and insomnia that may stand in the way of good sleep.
The “behavioral” aspect of CBT-i helps you develop personal sleep habits that, based on the science of sleep, will help you sleep better.
Here’s An Important Side-Note: Insomnia Defined
“Insomnia is defined as complaints of difficulty initiating sleep, maintaining sleep, waking too early, and nonrestorative sleep despite adequate opportunity plus a complaint of impaired daytime functioning (eg, fatigue, depressed mood, poor concentration).”
This video gives a nice overview:
(National Institutes of Health. State of the science conference statement on manifestations and management of chronic insomnia in adults, June 13-15, 2005. Sleep. 2005;28(9):1049-1057)
2. These Tips May Not Work For You
Yep, these tips may not work for you if:
You want a quick fix, like a pill.
You don’t like practicing.
But let’s face it.
Anything worth learning takes practice.
Do you have a child who is learning to play an instrument or a sport?
What do you tell your child?
“You’ve got to go to practice! You’ve got to get there on time, every time!”
You’ve probably paid good money for those lessons!
Why would you treat learning to sleep better any differently?
Be willing to take the time, effort, and even money to get your sleep.
Lack of sleep can cost you in startling ways.
It’ll take time to learn and practic these tips. You’ll be uncomfortable at first.
Its like learning anything else.
But you’ve got science based results on your side!
3. CBT-I (Cognitive Behavior Therapy for Insomnia) Tips To Help You Sleep Better
a) Get the CBT-i coach app.
It’s free! You can download either the iTunes or Android version by going to this page at the US Department of Veteran Affairs.
It’s not a substitute for seeing a professional sleep specialist, but you can still learn a lot from it.
In the Tools Section, Check out the Sleep Habits tips:
You’ll find detailed instructions on how to:
- Go To Bed Only When Sleepy
- Get Out of Bed When You Can’t Sleep
- Get Out of Bed At Your Prescribed Time
- Set Up Your Sleep Environment.
There is also information on Quieting Your Mind and Preventing Insomnia in the Future.
In the Learn Section, you’ll learn about Sleep 101 – the science of sleep, including why we sleep, the stages of sleep, sleep regulators, sleepiness versus tiredness, and PTSD and sleep.
You’ll also learn about habits that can hinder or help your sleep, and what to do instead.
You’ll learn about worrying in bed, watching the clock, napping, winding down, using the bedroom for only two activities, and eating, exercise, alcohol use, nicotine use, and getting comfortable.
Finally, you can use the My Sleep Section to take a sleep assessment, and to track your nightly sleep via sleep diaries.
b) Take the Insomnia Severity Index Sleep Assessment
This will help you get an idea for how much you feel insomnia is bothering you. If you’re working with a sleep therapist, you can share this with him or her.
You can take the assessment on a weekly basis to measure your progress over time.
c) Record Your Sleep Diary Every Day for At Least One Week
Again, it’s easiest to record your sleep diary in the cbt-i coach app.
On the other hand, you can go to this Insomnia Tools Page and check for the Master Sleep Diary calculator on the 4th row, right hand side of the page.
You can use that calculator to enter information from each evening.
As a side note, I’ve found that the fitbit I recently purchasedhelps me track the amount of time awake versus asleep during the night.
d) Once A Week, Update Your Sleep Prescription
If you’ve filled out your sleep diary every day for one week, the cbt-i coach app will automatically assign a regular “going to bed time” and “getting up time.”
Follow that schedule faithfully for each subsequent week, and you’ll see improvements in your sleep over time.
For example, I’ve been using the cbt-i coach for about a week as I prepare for this article.
This week, my sleep prescription has me going to bed at 11:30 pm and getting up at 6 am.
You might think it strange that part of practicing for better sleep means getting seemingly less sleep!
CBT-I researchers have found that by reducing the amount of time spent in your bed, you will create a greater demand in your body for sleep, so that when you are in bed, you’ll sleep more and wake up less.
Warning! You’re going to feel more tired the first three or four days that you try your sleep prescription.
Contrary to common beliefs, though, just because you feel tired does not mean that you’re going to suffer bad health effects.
After about a week, your sleep efficiency will determine whether to adjust your sleep schedule. If you’re sleep efficiency is under 80%, you’ll spend even less time in bed. If your sleep efficiency is between 80% and 85%, you’ll keep your schedule the same. But if your sleep efficiency is greater than 85% and you still feel tired, you can extend your time in bed each week by 15 minutes.
Note: If you are diagnosed with bipolar disorder or a seizure disorder, you should NOT practice sleep restriction.
e) Get up at the same time every day, 7 days a week!
This is easy to remember, but maybe not so easy to practice.
Our body has an internal clock.
When we get up at different times throughout the week it’s like putting our bodies through jet lag.
Help your body get its internal clock in sync by getting up the same time every day.
For example, I had recently been getting up between 6 am and 8 am depending on how I was feeling the day before.
But during the last couple of weeks, while prepping for this article, I’ve been getting up at 6 am every single day.
f) Go to bed only when sleepy
There’s a difference between feeling tired and feeling sleepy.
You want your body to understand when it’s truly time to fall asleep.
You and I also want to train our body to associate the bed with sleep, and not with wakefulness.
For example, I used to love to lie in bed reading articles or watching videos on my phone.
Over time, however, my body gets confused – “Wait,” thinks the body, “is the bed for falling asleep, staying awake, or trying to go to sleep?”
Sleep experts say that the bed is for two things only: sleep and sex.
Anything other than those two activities should be away from the bed.
g) Design a Bedtime Routine and Corner
Think about designing your own bedtime routine.
I don’t have a strict bedtime routine, but you can glean some ideas from this article called, A Bedtime Routine for Adults.
Since I’ve started using these cbt-i for sleep tips these last couple of weeks, I actually look forward to my evening routine.
Not only do I have my routine, but I also “hang out” in the living room downstairs (our bedroom is upstairs).
In this way, I have quiet and calm time to “wind down”.
In fact, I’m typing this article during my bedtime routine hour, close to the living room!
You can design your own place to “hang out” before going to bed.
h) Consider Meditation/Relaxation as part of your evening routine.
When we struggle to fall asleep, our bodies get keyed up and anxious.
Consider learning your own relaxation techniques to get ready for sleep.
i) Be careful with foods and substances
Drinking alcohol at night? Sometimes we get into the habit because it can make us drowzy.
Unfortunately, we’ll end up being more awake during the second half of the night.
Also be careful with caffeine. Consider keeping you last cup of coffee to lunchtime.
Caffeine can stay in the system up to 8 hours after consumption.
Also avoid heavy foods, like fried or greasy food.
Your Action Plan For Recovery from Insomnia
If you’ve gotten this far, I applaud you!
Insomnia and the resulting costs to you and your health are worth a recovery plan!
So here you go. I’m summarizing your next actions right now.
- Download the CBT-I (Cognitive Behavioral Therapy for Insomnia) Coach App right now.
- Pick a regular time to get out of bed every morning, no matter what, 7 days per week.
- Use your bed only to sleep!
- Design your own calming evening routine away from your bed.
- If you wake up and cannot fall asleep for more than 15 minutes, get out of bed and stay up until you’re sleepy.
- Avoid caffeine after lunch, and don’t eat dinner too late. Avoid heavy fried foods after dinner.
- Record your sleep diary in your cbt-i coach app every single morning.
- After a week, get your sleep prescription and follow that prescription, and you’ll see your sleep improving!
A Final Word: Growth Mindset
Use a growth mindset as you work on these tips.
Your health and your sleep are worth it.
Don’t get discouraged if you fall behind one or two days.
For example, I napped for an hour yesterday (you should not nap for more than 15-20 minutes during the day), and didn’t get out of bed this morning until 7 am! (I’m supposed to wake up at 6 am, get up at 6 am, but I heard the alarm, turned it off, and kept sleeping!).
But I’m going to start over tonight, go to bed at my prescribed time of 11:30 pm, and get up tomorrow at 6 am!
You can do the same. Don’t beat yourself up if you don’t follow every tip exactly. This takes practice, and it will pay big dividends in the long run.
P.S. If you’d like to try an online cognitive behavioral therapy program for insomnia, heres a helpful article, entitled Best Online CBT-I Programs. You’ll find a helpful description of the cbt-i coach app there.
The least expensive yet helpful progam of the ones listed appears to be the Conquering Insomnia Program. (not an affiliate link).
Taking Control of Your Life
I’m Steve Borgman, the owner of this blog.
I hope you enjoyed the above article.
If you’d like coaching and/or counseling to take control of your life, feel free to contact me for a free 15 minute strategy session.
Steve Borgman, LCPC, is a cognitive behavioral therapist and currently owns a private practice in Barrington, IL. To find out more about Steve, check Counseling and Psychotherapy in Barrington, IL.