We’ve all been there. The awful feeling of laying in bed after hours of restlessness and tossing and turning. Hours of looking at your clock and thinking “even if I go to sleep now I’ll still only get 4 hours, that’s not enough”. Dreading the next day after a night of insomnia.

As common as sleep issues are for people all over the world, many would be shocked by exactly how many habits we integrate into our daily lives that are preventing our minds and bodies from getting the REM we deserve. One of the best researched approaches to combatting insomnia is Cognitive Behavioral Therapy for Insomnia, or CBT-I. Research on CBT-I has shown improvement in the sleep of 70-80% of patients with primary insomnia, including greater ease of falling asleep, staying asleep, and feeling rested. In this post we will take a quick dive into the basics of CBT-I with the goal of identifying easy tips to overcome insomnia and get better sleep.

Changing your relationship with your bed

One of the most common “mistakes” we make in unknowingly contributing to insomnia comes from the time we spend in bed while not sleeping. For example, working, watching tv, scrolling social media, or simply just hanging out in bed. This creates a covert association in the brain between wakefulness and bed, which continues into the night when it's time to go to sleep. Changing your environment, or stimulus control, aims to remedy this issue by removing electronics and other “awake” activities from the room and committing to reserving bed for bedtime. In addition, at bedtime if you find yourself having difficulty falling asleep (for example, lying awake for 20 minutes), CBT-I encourages getting out of bed and moving to another location until your body feels ready for sleep. In short, it's important to make sure your bedroom is a place only for sleeping and sex.

Saying no to napping

As difficult as this one is, sleep experts recommend refraining from naps during the daytime in order to establish a more regular sleep routine. Although it feels great to take a nap during the day after a night of tossing and turning, it can unintentionally create a change in your circadian rhythm (the “internal clock” that regulates patterns of sleep and wakefulness). A nap once in a while can be a nice act of self-care, but if you struggle with insomnia, experts recommend saying no to naps, as it can make it even harder to fall asleep at night.

Changing your negative thoughts

For people with insomnia, negative thoughts and negative experiences related to sleep often compound on each other in a draining positive feedback loop. When we have a negative experience with sleep it can create negative beliefs about our ability to sleep, which then increases sleep difficulties even more. An important part of CBT-I is working on identifying and challenging these negative thought patterns. Here’s an example:

“Tomorrow is going to be awful if I don’t fall asleep now” —> “I’ve gotten through lots of days after little sleep in the past (for example, after my friend’s birthday party last month), I can do it again today” “I’m going to have insomnia forever”; “I’m never going to sleep normally again” —> “I have new tools and resources to help me sleep that I didn’t have before when sleeping was the hardest”

Learning to relax

Oftentimes the first step the average person will take if they are unable to sleep is to roll over and grab their phone to distract themselves from the distressing thoughts and worries about sleep. Although this may help for a while, distractions are more like a bandaid than a treatment when it comes to insomnia. Learning new techniques to relax your body can have a large impact on both your anxiety and your readiness to sleep, because it allows for your brain to signal to its sleep centers that it's time for bed. Some examples of relaxation techniques recommended by CBT-I experts include: progressive muscle relaxation, meditation (guided or independent), breathing exercises, and autogenic training. I’ll include some links below to resources to try these at home yourself.

Lifestyle changes

The last area commonly covered in CBT-I is working on making lifestyle changes that can help support a healthy sleep routine, such as making changes to diet and exercise. An easy diet change to make can be as simple as having dinner earlier in the evening to allow your body to digest your food before getting into bed. Another helpful diet tip is avoiding caffeine for 6-8 hours before bedtime. In regards to exercise, some studies show that moderate intensity exercise can be beneficial for sleep when done at least an hour prior to bedtime. Others show that exercising outside during the day can be especially helpful for regulating your circadian rhythm.

Final thoughts…

You are not alone in your struggle with insomnia. If you or someone you know is dealing with sleep difficulties there are always professionals willing to help. Whether that’s talking with your primary care doctor about the medical approach to insomnia or getting the support of a therapist to walk through your CBT-I journey, there are more resources available than what your anxious brain might tell you at 3am. You will be able to sleep again!

Breathing exercise for sleep: https://www.youtube.com/watch?v=j-1n3KJR1I8 — opens in a new tab Progressive muscle relaxation: https://www.youtube.com/watch?v=5q3K-6HvQIk — opens in a new tab Guided meditation: https://www.youtube.com/watch?v=U6Ay9v7gK9w — opens in a new tab Autogenic training: https://www.youtube.com/watch?v=P-_6GlnlOtM — opens in a new tab