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What is CBT-i for sleep insomnia and how does it work?

woman suffering from insomnia considering CBT-i

Cognitive Behavioural Therapy for Insomnia (CBT-i) is an evidence-based treatment specifically designed to address chronic insomnia. Unlike medication, which often provides only temporary relief, CBT-i focuses on changing the thoughts and behaviours that contribute to sleep difficulties, offering a long-term solution.


This therapy is rooted in both cognitive and behavioural interventions that help you develop healthy sleep habits and improve your overall mental health and wellbeing.



Key components of CBT-i for sleep insomnia


  • Sleep education: Understanding the science of sleep is essential for improving sleep quality. We provide detailed information on sleep cycles, sleep stages, and the various factors that affect sleep, helping you appreciate the importance of good sleep hygiene.

  • Sleep hygiene tips: Good sleep hygiene is foundational to improving sleep quality. This includes practical advice on creating an optimal sleep environment—such as maintaining a cool, quiet, and dark bedroom—and establishing a regular sleep schedule. Avoiding caffeine and heavy meals before bedtime, limiting screen time, and engaging in relaxing pre-sleep activities are all part of our comprehensive sleep hygiene recommendations.

  • Stimulus control: This technique helps you create a strong association between the bed and sleep. It involves only going to bed when sleepy, getting out of bed if unable to sleep within 20 minutes, and using the bed exclusively for sleep and intimacy, not for activities like watching TV or eating.

  • Sleep restriction: While it might seem counterintuitive, limiting the amount of time you spend in bed can increase your sleep drive and improve sleep efficiency. This technique involves restricting your time in bed to the actual amount of time you are currently sleeping and gradually increasing it as your sleep improves.

  • Cognitive therapy: Insomnia often comes with negative thoughts and beliefs about sleep that perpetuate the condition. Cognitive therapy aims to identify and challenge these thoughts, replacing them with more realistic and positive ones. This process helps reduce anxiety and promote a healthier sleep mindset.

  • Relaxation techniques: Relaxation is key to preparing your mind and body for sleep. Our programme includes various relaxation techniques such as deep breathing exercises, progressive muscle relaxation, and mindfulness meditation. These practices help reduce stress and create a calm state conducive to sleep.


CBT techniques for better sleep


These techniques are designed to address the specific challenges of chronic insomnia and promote lasting improvements in sleep quality.

  • Cognitive restructuring: This technique involves identifying and challenging negative thoughts about sleep. For example, if you believe that you will never be able to sleep without medication, cognitive restructuring helps you develop a more balanced view, such as recognising the effectiveness of behavioural sleep medicine.

  • Behavioural interventions: These include techniques like sleep restriction and stimulus control, which help regulate your sleep patterns and reinforce positive associations with sleep.

  • Mindfulness and relaxation: Incorporating mindfulness meditation and other relaxation exercises can help reduce pre-sleep anxiety and create a state of calm that is conducive to sleep.


Exercises for sleep improvement


CBT-i includes various exercises designed to improve sleep. These exercises are practical, easy to follow, and can be integrated into your daily routine:


  • Sleep diaries: Keeping a sleep diary helps track your sleep patterns and identify factors that might be contributing to your insomnia. This data is invaluable for tailoring the CBT-i programme to your specific needs.

  • Thought records: These exercises help you document and challenge negative thoughts about sleep. By writing down your thoughts and analysing them, you can develop more balanced and positive perspectives.

  • Progressive muscle relaxation: This exercise involves tensing and then slowly relaxing each muscle group in your body, promoting physical relaxation and reducing tension that can interfere with sleep.


Natural remedies for insomnia


In addition to CBT-i, we often recommend natural remedies for insomnia that can complement your therapy. These include herbal teas like chamomile, valerian root supplements, and aromatherapy with essential oils such as lavender.


While these remedies can be helpful, it’s important to discuss them with your specialist to ensure they fit well with your overall treatment plan.


Behavioural sleep medicine


Behavioural sleep medicine encompasses a range of non-pharmacological treatments for sleep disorders, including CBT-i. This field focuses on the behavioural, psychological, and physiological factors that affect sleep.


At Schoen Clinic Chelsea in London, we incorporate the latest advancements in behavioural sleep medicine to provide the most effective treatment for insomnia. If you'd like to book an assessment with our CBT-i for sleep insomnia expert, Consultant Psychiatrist Dr Greg Shields, please don't hesitate to contact our team today.

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