Exploring CBT for insomnia

Prompted by a comment @triplethreat3 asked a little while ago that discussed the potential benefits of CBT, I wanted to learn more about Cognitive Behavioural Therapy for myself, and specifically its application for healthier sleep.

I was surprised by how counterintuitive some of the techniques seemed to me (drastically limiting time in bed, trying deliberately to stay awake, etc.)! despite understanding the psychological reasoning behind why they do work.

One of the core benefits of CBT-I is that instead of merely treating the symptom (consider how sleeping pills work temporarily to bring on sleep), CBT-I focuses on addressing the underlying causes of the problem, treating the symptoms where they first began.

For many of us that can be sleep anxiety, or not being able to “switch off” because of racing thoughts. I definitely tend to experience more of the latter, and staring at a screen for most of the day, I’m sure does not help!

In a clinical setting, CBT-I is carried out by a healthcare professional. Over the course of several sessions, a sleep clinician is responsible for the assessment, diagnosis, and implementation of CBT practices into the everyday life of the client, but that isn’t to say that individuals can’t benefit from applying CBT-I techniques at home.

Has anyone had success with CBT - either in a clinical setting or applying a few of the practices at home?

Linking the articles below also for reference :slight_smile:

What is CBT?

3 Techniques of CBT-I

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Hey @alexwalkerjones,
I have had quite a lot of experience with child/teen CBT -mainly in a clinical setting-, both positive and negative. I started receiving CBT sessions as a child -age 9- as I was struggling with extreme social anxiety and OCD, which led to me not being able to leave the house. Personally, as a child I found CBT very helpful, the approach was a slow process and was all about focusing on taking baby steps until I was able to start coping on my own using the skills that CBT had taught me, however as I said before, it is not a quick process, all-in-all I received CBT sessions for approximately 2 years, so it can get slightly frustrating as it takes a while to start recognising any sort of ‘improvements’, but I would argue that it was definitely worth the time it took, as I did see a major improvement in myself and my life.
More recently I started attending CBT sessions again, yet this time it was because I wanted help with general anxiety and low moods, personally, I did not find it helpful this time around as I feel as though it didn’t handle those emotions/symptoms very well, though this may be due to the fact that I didn’t particularly connect well with the therapist I was given who was providing the CBT sessions.
So all-in-all, I would say CBT can be very helpful if you are prepared to not see instant or fast positive changes, however, it is very dependent on how well you get on/connect with the person/therapist who is giving you Cognitive Behavioural Therapy.
Has anyone else had any experience with CBT specifically for sleep? If so did you find it differs between sleep/anxiety?

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So proud of you and absolutely love your comment xx :hugs: welcome to the treehouse @eveyvandenheuvel ! Ps love to hear from @pamelaspence and @stephendahmermd - of their experiences with CBT.

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Hello @eveyvandenheuvel, nice to see you in the Treehouse :blush:
You know, I had mixed feelings about CBT because I come from a background of person centred care that values giving people the time and space to explore their feelings. When CBT came along it quickly became popular within settings like the NHS because it is effective and easily measure but a lot of us felt that it was leaving out the more subtle art of counselling and the deeper resolution people can find when they discover it themselves in a less constructed way. The ease with which you can learn the technique also led to practitioners setting up having done a very basic training and without the clinical experience to hold space safely for patients. However… then I realised that actually some people get worse revisiting and reflecting on their emotions when in a highly emotional state. And that CBT actually offers a toolbox beyond exploration which is extremely useful to get people to a better place with phobias, anxieties and the like.
So I guess now I believe that it absolutely has its place, and can be very effective but I agree with you, you need to feel rapport with your therapist or that is likely to get in the way of a positive outcome.

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Thanks–appreciate all of the other comments. I’m with Pamela to a large extent, because it seems like such a simple solution that it’s easy to use it as a shortcut. On the other hand (and why I often recommend it) is because even if it can be a half-solution shortcut, many of my patients would rather that shortcut than the most common shortcut (e.g. taking a sleeping pill). And I hate prescribing what will likely be a long-term medicine if I can avoid it. So although I share everyone’s reservations, I often recommend it in part because the evidence supporting it is quite good, and because for many people it’s better than yet another prescription.

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