Combine CBT methods for best results

Q:  After dealing with insomnia for months, I am looking for solutions without drugs.  Some experts say if you don’t fall asleep within about 20 minutes, get up and out of bed.  Others say stay in bed and try to relax.  Which is better?

A:  You are wise to seek non-drug solutions to insomnia.   Primary insomnia is not some sort of a disease you can treat with drugs like sleeping pills.  Insomnia is a complaint.  Sleep, or rather the lack thereof, is only the symptom.

Your first step should be to see a doctor to either treat or rule out an underlying medical basis.  But don’t be surprised if you have none.  Most insomniacs don’t.  In that case, look at the much more common nonmedical reasons for your sleep issues.

Most primary insomnia is typically caused by some combination of bad sleep habits and excessive worry about the idea of sleep.  Identifying and treating the true underlying basis can lead to a permanent solution.

You’ve described getting up and out of bed when you can’t sleep, which is part of what’s known as stimulus control.  This is one core method of CBT sleep training. The idea is to begin to undo the negative conditioning you have likely acquired between your bed and the idea of sleep.

The second method you’ve described is in-bed relaxation, also one of the core CBT sleep training tools.

Which should you use?  Both are important components of a permanent insomnia solution.  The answer will be unique to you, and a judgement call only you can make.

If you are lying in bed, tense and worried, not in the least bit drowsy, then that’s the time to get up and out of bed and do something sedentary and relaxing until you feel drowsy.  Then try sleep again.

But if you are lying in bed with eyes closed, drowsy but persistently awake, you can help yourself fall back asleep more quickly by practicing some in-bed relaxation methods.

Importantly, these are only two of many effective CBT methods you can and should use to help restore normal sleep.  Another essential one is cognitive restructuring, which allows you to get a handle on the negative sleep thoughts that are likely fueling your insomnia to some degree.  Another is sleep timing, a behavioral method which enables you to set and keep a sleep-supportive schedule specific for your needs.  Yet another is sleep hygiene.

All these methods reinforce one another and combine very effectively.  They work best when used simultaneously.

To do this, consider using a full and comprehensive CBT sleep training program.  This will give you the structure and support to deploy all these methods at once.  By doing so, be confident you will improve your sleep permanently, and without drugs.

 

Explore posts in the same categories: Health, Insomnia, sleep

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