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Effective Psychological Treatment for Sleep: CBTi


Cognitive Behavioral Therapy for Insomnia (CBTi) stands out as the primary evidence-based psychological treatment for sleep disorders. Endorsed by the National Institute of Clinical Excellence (NICE), CBTi has proven as effective, if not more so, than many sleep medications for a vast majority of individuals.
Several avenues are available for those seeking CBTi, including literature, digital applications, and in-person therapeutic sessions. While all methods hold merit, many find the direct interaction of face-to-face therapy to be invaluable. As a psychotherapist, I offer an added dimension by assisting my clients in unravelling potential triggers for their sleep disturbances, complemented by a structured CBTi program.

One of the critical factors in this process is understanding that you need to be sleepy to sleep - you can't force yourself or try to sleep.


The Five Pillars of CBTi
Sleep Hygiene:

At its core, sleep hygiene constitutes a collection of recommendations encompassing lifestyle choices, dietary habits, caffeine and alcohol consumption, and environmental variables like lighting, noise, and temperature. These factors can either enhance or disrupt sleep. Part of this involves educating clients about the nuances of "normal" sleep and how it evolves with age.
       

Cognitive Therapy:
This focuses on replacing sleep-related negative thought patterns with a more constructive outlook. This shift helps transition individuals from a frustrated stance of fighting sleep to naturally permitting it. Central to this is the understanding that one needs to be sleepy to fall asleep; trying to force or will oneself to sleep is counterproductive. This shift helps transition individuals from a frustrated stance of willing sleep to it naturally occurring. Such an approach equips you with the tools to mitigate and control potential relapses effectively.

Sleep Restriction:
Counterintuitively, spending too much time in bed can make sleep issues worse. By deliberately reducing bedtime, one conditions the body to optimise the time allocated for sleep. This method intensifies sleep pressure, concentrating it to ensure reduced awakenings and heightened sleep efficiency. Although research touts its effectiveness, often paralleling medications, it demands dedication and initial tolerance of potential sleep disruptions. 


Relaxation Strategies:
Striving aggressively to improve sleep often becomes counterproductive. A focus on relaxation, both during the day and before sleep, can significantly alleviate sleep issues. Through our sessions, we will explore a repertoire of relaxation techniques tailored to your needs.


Stimulus Control:
This strategy targets the dread of sleeplessness that often perpetuates insomnia. If sleep remains elusive after 15-20 minutes, I advocate leaving the bed. Our sessions will delve into specific actions to undertake during such sleepless moments.


Embarking on the Therapeutic Journey
Before we begin, I'll request that you complete a comprehensive health questionnaire. This step is crucial to discern any underlying clinical sleep concerns that might necessitate medical intervention. As sleep disturbances can arise from various sources, it's imperative to pinpoint their origins. Subsequently, in our first session, we will strategise and chart out the path forward.

 

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