Consistent, quality sleep can be a problem for many individuals in the USA. Insomnia is a sleep disorder in which a person has difficulties initiating and/or sustaining sleep, or the complaint of nonrestorative sleep that occurs on at least 3 nights a week and is associated with daytime distress or impairment (WHO, 1992) with the Academy for Sleep Medicine identifying primary insomnia as insomnia that is not due to an underlying medical and/or psychiatric or environmental condition (AASM, 2008). While not the only sleep disorder, insomnia affects over 1/3rd of the adult population and can be the result of medical, psychiatric, substance abuse or other conditions.

Cognitive Behavior Therapy for Insomnia (CBT-I) is a well-established and proven treatment approach particularly for those with insomnia that is not complicated by other sleep-disruptive conditions.

CBT-I is based on the 3-factor model of insomnia, developed over 30 years ago by Dr. Arthur Spielman, which puts forth three primary factors that contribute to chronic insomnia: 1) predisposing factors (traits/conditions); 2) precipitating factors (situational conditions); and 3)  perpetuating factors (behaviors and thoughts that contribute to the transition from acute to chronic insomnia) (Spielman, 1986). CBT-I treatment is short-term (between 6-8 session) and involves the therapist conducting an insomnia assessment and providing clients, receiving education about sleep developing a sleep diary, sleep restriction, stimulus control, and relaxation training, strategies to reduce sleep-interfering thoughts and worries, and stress management. Unique to CBT-I is the therapy’s focus on aligning bed time and rise time the person’s internal clock.

Reference:

American Academy of Sleep Medicine. (2008).Retrieved online at https://aasm.org/resources/factsheets/insomnia.pdf

Speilman, A.J. Assessment of insomnia. Clinical Psychology Review, 1986, vol.6(1), pp. 11–25.

World Health Organization. The ICD-10 Classification of Mental and Behavioral Disorders: Clinical descriptions and diagnostic guidelines. Geneve. World Health Organization. 1992.