What is CBT for insomnia (CBTI)?
Hey sleep enthusiast, are you curious about how CBT can help with insomnia? With Restful Sleep coaching, CBTI is one of many modalities used, along with integrative sleep therapy, embodiment practices and more, in an approach to directly impact the needs of the client. Read on to find out more about CBTI and try some exercises out for yourself.
11 min read
As a sleep coach, and sleep geek, I’m passionate about sharing how CBTI, or CBT for insomnia, can be used with other modalities in sleep coaching to improve people's quality of life. That's both when it comes to their waking life and Restful Sleep. This article is all about what CBTI has to offer:
What is CBT for insomnia (CBTI)?
Sleepfoundation.org describes Cognitive behavioral therapy for insomnia as ‘a short, structured, and evidence-based approach to combating the frustrating symptoms of insomnia.’
The modality is an extension of the well-known talking therapy, cognitive behaviour therapy (CBT). CBT has been scientifically researched and has more evidence to support it than any other form of therapy. This approach can be used to treat a range of psychological issues, from anxiety, to stress to sleep struggles.
CBTI focuses on exploring the connection between the way we think (cognitive), what we do (behaviour) and how we sleep. The intention of the treatment focuses on getting clarity on specific thoughts, feelings and behaviors that relate to insomnia. From there, goals and an action plan can be created for concrete steps to more consistent, restful sleep.
How does CBTI relate to everyday life?
When I start working with clients as a sleep coach, one of my first invitations is to see if they can start to see everything that happens in life as containing something to learn from. I’m talking about everyday interactions that may not have been given too much attention before, such as:
Your relationship with your phone, when and why you may cling onto it, what needs is may be fulfilling.
Levels of 'revenge bedtime procrastination', the common behaviour of putting off sleep despite feeling sleepy.
Habitual ways you may not speak up when you have a chance (and then end up ruminating over at night).
Simply calling yourself a "bad sleeper" ("that's just the way it is for me"), which perpetuates that identity and correlated behaviours.
Whether experiences bring initial reactions of joy or frustration, satisfaction or disappointment, the invitation is can you get curious about what is going on for you? Whilst this mindset definitely takes some practice and may not always be available in the moment, being able to reflect on and bring curiosity to everyday events is a great place to start from when it comes to building the skills to clarify or reframe thoughts and feelings.
Can I practice CBTI on my own?
When people ask ‘can I practice CBTI on my own?’, I am delighted to share that the therapy is totally accessible for people to explore both solo or with a therapist or coach. There’s an exercise you can also try from CBTi further down this page if you’re curious how it might be. There are also many free CBTi resources and worksheets available for you to work through online.
As well as following the CBTI exercises on worksheets, keeping a sleep-focussed journal can also be helpful, using prompts from worksheets to inform both the journaling habit and reinforce the intention of curiosity around what happens in everyday life. If you are able to commit to regular practice time and reflect on your experiences with self-awareness, CBTI can be a great tool for inner work that you can explore alone.
How can I benefit from working with CBTI?
Many clients come to Restful Sleep coaching having heard of the positive results that others have experienced with CBTI, but they don’t have the energy to research the process and create their own action plan. They want clarity on what is required of them and how the modality may be able to improve their sleep struggles.
Once we begin the coaching process, clients tend to want support when it comes to getting the most insight from the exercises, as well as wanting someone to keep them accountable because it can be tough to keep up the willpower when introducing some of the changes suggested by CBTI. This includes seeing more into potential blind spots about where they are at to expand their perspective and explore new ways of being.
Can CBTI be used for sleep anxiety?
When it comes to the psychoeducational aspect, which is thoughts about thoughts, a common struggle for clients is experiencing anxiety before bed, or when trying to sleep.
Night-time anxiety can come about through anticipatory thoughts like ‘what if I can’t drop off to sleep tonight’ or ‘I’m going to have a terrible day tomorrow because of this lack of sleep’. I also hear common thoughts like ‘I won’t be in the mood to show up for much tomorrow, I’ll do the bare minimum so I can catch up on rest’ and ‘why can other people just nod off and I’m stuck here worrying about sleep, it’s not fair’.
When going through a rough sleep patch, anxiety can peak with anxious thoughts turning into desperate Google searches seeking reassurance with ‘how long can you go without sleep before hallucinating?’, ‘can you go into a coma from a lack of sleep’ and even ‘can you die from not sleeping?’.
The good news is that insomnia won't kill you, and managing anxious thoughts is a skill that can be built over time. Part of the power of getting a coach to support you is in catching these thoughts and beliefs as they happen to reflect them back to you. As well as bring there to witness you where you are at, offering support, answering questions and giving challenge when it feels safe to do so. If you'd like to find out more about sleep coaching could help with your sleep struggles, you can find out more about one on one sleep coaching and schedule a free fifteen minute consultation call here.
What is something from CBTI to try?
A good place to start with CBTI is the basic sleep rules, as these offer practical guidance for creating consistency and building supportive habits for your sleep routine.
If you are finding yourself struggling to sleep due to racing thoughts right now, you can learn more about managing rumination here. This is when the mind is taken up with thoughts, which often repeat and don't meet a conclusion.
When experiencing ruminating thoughts at night, the mental activity can bring tension and activation of the nervous system. This blocks feelings of sleepiness and contribute to insomnia.
How is CBTI used in Restful Sleep coaching?
Restful Sleep coaching is customised to the individual, drawing on exercises from CBTI, as well as embodiment practices and taking a holistic approach. The practical sleep hygiene tips from CBTI are typically used in the early stages - after you've shared your goals and we've done some initial explorations into your struggles.
We then prioritise what to explore in an action plan, to keep changes manageable and motivating. A key benefit of Restful Sleep coaching is receiving support and accountability to help with sticking with the small, repeated actions that lead to results.
If you'd like to find out more about how CBTI could help your sleep, you can take your first step to Restful Sleep and book a free consultation call today.
Embodiment and how it affects sleep
How nourishing our body can support sleep (or not), from food and exercise to drinking coffee and alcohol.
The holistic approach to sleep coaching
How factors from across your lifestyle can block sleep - and how you can make changes.