If you have occasional trouble sleeping or you’re living with a sleep disorder, you may wonder if you’ll ever get a good night’s sleep again. Fortunately, there are several proven strategies you can learn and practice at home. These include relaxation training, cognitive therapy, stimulus control, sleep restriction therapy, and better sleep hygiene, according to neurologist Alon Y. Avidan, MD, MPH, director of the UCLA Sleep Disorders Center.
The first step, however, is identifying the cause of your sleep problem. “There are many different types of sleep problems including insomnia, sleep apnea, restless legs syndrome, and excessive daytime sleepiness,” Dr. Avidan says. “Therapy has improved over the past few years. New medications target specific sleep centers in the brain. They also are more efficacious and cause fewer side effects.”
Change your thinking One of the more encouraging treatments for insomnia is cognitive behavior therapy (CBT). CBT is also used to treat conditions such as depression, anxiety, substance abuse, eating disorders and various mood and personality disorders. The idea is that the way you think and feel about a situation affects your behavior regarding that situation. So if you can change your thoughts and feelings, your behavior will follow suit.
“CBT is especially effective for insomnia,” Dr. Avidan says. “Just make sure to find a therapist who treats your specific disorder. Therapy for people with insomnia focuses on changing their perspective and reinforces proper sleeping techniques. These include practicing good sleep hygiene.”
Sleep hygiene includes your behaviors right before going to bed and the environment you create in your bedroom. For example, avoiding alcohol and caffeine before bedtime is considered good sleep hygiene. So are strategies such as making the bedroom very dark, keeping the air cool and avoiding TV, computer and smart phone screens as you try to fall asleep.
CBT-I, the phrase used to describe cognitive behavior therapy for insomnia, also seeks to address anxieties you might have about falling asleep. You might be someone who tends to focus on negative thoughts and worries late at night, and those thoughts may keep you from relaxing and falling to sleep. CBT-I changes your bedtime thinking and teaches you skills to avoid thoughts that contribute to insomnia.
“CBT may be better than pills for the treatment of disorders like insomnia because it goes to the core of the behavior,” Dr. Avidan says. “But as is the case with all therapy, the patient has to be committed to therapy and following the counselor’s suggestions. I’ve found that patients who are treated with CBT for sleep disorders are often extremely satisfied with the outcome and tend to benefit substantially… Medications combined with cognitive behavioral therapy (CBT) tend to work very well.”
CBT specifics CBT usually involves talking with a therapist and applying strategies learned in therapy sessions. For example, if your CBT sessions include stimulus control therapy, you may learn to approach bedtime, wakeup time and all the hours in between differently. You may learn to think of bed as a place only for sleep and sex. You may be urged to follow a strict bedtime and wakeup time every day. Learning and applying any and all of these strategies may be just what you need for a good night’s sleep.
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