Insomnia is one of the most common sleep disorders. It is estimated to affect about 30% of people at some point in their lives, and the currently recommended treatment is Cognitive-Behavioral Therapy for insomnia (CBT-I), which is an effective way to reduce and eliminate the symptoms of insomnia .
What is insomnia?
When a person has difficulty falling asleep or is unable to sleep, he or she may be experiencing insomnia. There are three main complaints related to insomnia:
· Take time to fall asleep after lying down (usually more than 30 minutes).
· Wake up during the night and take a while to get back to sleep.
· Waking up earlier than usual and not being able to go back to sleep.
Some people may experience a condition called transient insomnia (or acute insomnia), which can last up to three months. Transient insomnia can be linked to a stressful period, an acute illness, hospitalization, or a significant life event. So while acute insomnia is a problem and must be treated, it is not necessarily an illness, but a reflection of something going on.
Chronic insomnia occurs when the person persists with these symptoms for a longer period of time (more than three months). Environmental, genetic, or underlying conditions can trigger this disorder; but the main causes are usually behavioral. In this case, the person who is suffering from acute insomnia becomes involved in behaviors and habits that end up making it chronic.
Other medical conditions or sleep disorders can also be associated with insomnia such as restless legs syndrome, chronic pain, depression, anxiety, kidney disease, arthritis, Alzheimer's disease, among others.
What is cognitive behavioral therapy for insomnia (CBT-I)?
CBT-I is the first choice of intervention used in the treatment of chronic insomnia, as insomniac people often develop negative thoughts and behaviors regarding sleep. CBT-I consists of a specific psychotherapeutic approach focused on the causes and symptoms of insomnia, being performed by a series of visits to a psychologist specialized in this type of treatment.
The purpose of this therapy is to equip you with cognitive and behavioral techniques that allow you to solve problems related to your sleep difficulties, creating a more peaceful sleep environment, positive and assertive attitudes, as well as modifying the negative associations related to sleep in more realistic and positive associations.
Is CBT-I effective?
Yes! Fortunately, CBT-I is a lasting solution. Research so far has shown that CBT-I should be the first choice for the treatment of insomnia according to the American Sleep Association. The results also show that CBT-I is the most effective intervention in the long term, when compared to sleeping medication, and its effectiveness has also been proven by scientists and physicians.
Different studies have already investigated the effectiveness of this therapy. In other words, contrary to what is generally thought, the correct way to treat insomnia is not only with medication, but through cognitive and behavioral measures, in this case the CBT-I.
In addition to insomnia, CBT-I has been shown to be effective for some other conditions that affect sleep, such as anxiety, depression, and chronic pain.
How does CBT-I work?
The CBT-I standard program involves 6 to 12 week sessions and includes different approaches and techniques, which can be specific to each case. It can include stimulus control, sleep restriction, biofeedback, relaxation, and sleep hygiene education. Everything is monitored by a sleep specialist, who assesses your condition at each weekly session and adjusts the treatment according to your needs and evolution.
- Education and sleep hygiene
One of the first strategies a sleep specialist does is to examine your lifestyle habits. People tend to do certain things that interfere with their nightly rest, without them noticing. That's why it's crucial to learn about good sleep hygiene and make some adjustments to help you sleep better.
This includes, for example, maintaining a regular sleep schedule, making your bedroom pleasant to sleep in, avoiding screen time for at least 45 minutes before bed, creating a relaxing bedtime routine, eating a balanced diet, and exercising regularly. .
In addition to all these techniques and education, a sleep specialist will discuss everything with you during the weekly therapy sessions. They can uncover underlying sleep problems, tell you where you went wrong, and point solutions in the right direction.
- Stimulus Control
Stimulus control aims to reinforce positive associations with sleep and get rid of any disturbing thoughts that make it difficult to start and maintain sleep. With insomnia and failed sleep attempts, the brain begins to associate the bedroom with a place of stress and anxiety. With therapy, your brain learns to recognize the bedroom as a place for relaxation and rest at night, thus allowing for quality sleep.
- Sleep restriction
People with insomnia usually stay in bed for a long time, however, more time spent in bed does not necessarily mean more sleep. Sleep restriction aims to reduce this time spent in bed when you are not sleeping. The goal is to increase the time you are sleeping and reduce the time you are lying without sleep. Sleep restriction appears to have the opposite of the desired effect at first, but over time, falling asleep becomes more comfortable and sleep increases.
- Biofeedback and relaxation techniques
These are techniques for calming yourself down and getting into a relaxed state to facilitate sleep. Devices (eg wristbands) are typically used that capture biometric information about your body, such as movement, temperature and heart rate, which are used to assess and improve your state of relaxation.
When to look for help?
If you occasionally get a bad night's sleep, there's probably nothing to worry about. However, if the problems persist for some time and your everyday life and performance are affected, then it's time to seek help.
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