What Does Behavioral Insomnia Treatment Involve?

Behavioral intervention for insomnia typically involves cognitive behavioral therapy (CBT) and the practice of good sleep hygiene. When you enter into a structured program for CBT and/or sleep hygiene, it allows you and your doctor to identify and correct negative thoughts or actions that are potentially causing your sleep problems. Behavioral insomnia treatment can help you overcome the underlying causes of insomnia, without the need for sleeping pills. 

Cognitive Behavioral Therapy for Insomnia (CBT-I)

Cognitive behavioral therapy is an evidence-based therapy used to teach people ways to fall asleep faster, stay asleep longer. teaches you to recognize and change beliefs that affect your ability to sleep. This type of therapy can help you control or eliminate negative thoughts and worries that keep you awake.

The behavioral part of CBT-I helps you develop good sleep habits and avoid behaviors that keep you from sleeping well. Depending on your needs, your sleep therapist may recommend some of these CBT-I techniques:

• Stimulus control therapy - This method helps remove factors that condition your mind to resist sleep. For example, you might be coached to set a consistent bedtime and wake time and avoid naps, use the bed only for sleep and sex, and leave the bedroom if you can't go to sleep within 20 minutes, only returning when you're sleepy.
• Sleep restriction - Lying in bed when you're awake can become a habit that leads to poor sleep. This treatment reduces the time you spend in bed, causing partial sleep deprivation, which makes you more tired the next night. Once your sleep has improved, your time in bed is gradually increased.
• Relaxation training - This method helps you calm your mind and body. Approaches include meditation, imagery, muscle relaxation and others.
• Remaining passively awake - Also called paradoxical intention, this involves avoiding any effort to fall asleep. Paradoxically, worrying that you can't sleep can actually keep you awake. Letting go of this worry can help you relax and make it easier to fall asleep.
• Biofeedback - This method allows you to observe biological signs such as heart rate and muscle tension and shows you how to adjust them. Your sleep specialist may have you take a biofeedback device home to record your daily patterns. This information can help identify patterns that affect sleep.

What Is Sleep Hygiene?

Sleep hygiene refers to lifestyle behaviors and actions that can improve the duration and quality of your sleep. To begin practicing good sleep hygiene, try to:

• Get up at the same time every morning (including weekends)
• Avoid caffeine after 12 p.m.
• Abstain from alcohol and nicotine in the evening
• Decrease stimuli in your bedroom (e.g. activate a blue-light filter on your phone, turn off the TV)
• Try to avoid using light-emitting screens
• Exercise 4 to 5 hours before your targeted bedtime
• Do not nap during the day