Insomniacs have easier access to drug-free therapy, thanks to apps and Internet courses offering CBT-I — Cognitive Behavioral Therapy for Insomnia.
The sleep-specific therapy was initially created to deal with sleeplessness that occurs in the middle of one's sleep, rather than those who have trouble falling asleep when first going to bed. Components of CBT-I include a focus on good "sleep hygiene," such as reserving time spent in bed for sleeping only, and strategies for eliminating worry about sleeplessness.
Jennifer Martin, a licensed clinical psychologist and professor at UCLA’s David Geffen School of Medicine, explained why some, including the American College of Physicians, think CBT-I is a better first choice than sleeping pills.
“What they’re talking about is not a night or two of poor sleep, but people who really suffer from poor sleep for several months that’s severe enough to make it hard for them to function during the day,” she said. “In those instances, what the research shows is that cognitive behavioral approaches had the best long-term outcomes. The American College of Physicians felt like cognitive behavioral therapy was safer, in terms of a first line therapy, and had better outcomes over the long term than using medication.”
Still, it’s not feasible for everyone to see a sleep professional. Instead of seeing a CBT-I therapist to game out individualized analysis, online sleep programs can effectively, track, analyze and find solutions for insomniacs.
Martin discussed how such apps and online solutions can help users get better sleep, as well as sharing some simple suggestions for improving your nightly rest.
5 tips for better sleep from Jennifer Martin:
- Try not to worry about falling asleep: “Sometimes I’ll describe to patients that the biggest monster in their bedroom is the insomnia itself. [It] can be what keeps people awake at night, worrying about what’s going to happen the next day and what’s going to happen in the long run.”
- Be active and have a daily routine: “A good amount of sleep is really based on how you feel and function during the day. There isn’t really a specific numbers of hours or minutes [of sleep everyone should get].”
- Use a clinically-tested sleep tracking app: “Typically what people will do is keep a log of their sleep habits through the app, and then the app will use that information to make an initial set of recommendations. Then, they follow that for a period of time — usually a week — continuing to monitor their sleep, and then the app will continue to make adjustments to their recommendations.” (One such app: CBT-i Coach, created by the U.S. Department of Veterans Affairs.)
- Spend less time in bed: “Insomniacs have a tendency to cast a wide net and try to catch sleep any time they can. Oftentimes they end up spending too much time in bed.”
- Practice mindfulness-based relaxation exercises: “Learning and applying techniques to be relaxed at bedtime is actually a core components of CBT-I. Guided meditation is a great tool for that. One of the challenges that people with insomnia have is their anxiety level starts to go up as they approach bedtime.”
This interview has been edited for clarity.
Jennifer Martin, Licensed Clinical Psychologist specializing in CBT-I; Associate Professor, UCLA’s David Geffen School of Medicine
This story has been updated.