Insomnia
What is Insomnia?
Most people know how painful a bad night sleep can be. In fact, most people have short periods of time in which they have poor sleep; for example, during periods of stress or perhaps most famously, after the birth of a child. Lack of sleep can leave a person feeling exhausted, grumpy, sluggish, and out of sorts. It can be difficult to concentrate or make decisions, and completing simple tasks may feel like a chore. When we feel this way, all we want to do at the end of the day is sleep!
People who suffer from insomnia experience long periods of time without good sleep. They usually experience difficulties in getting to sleep, staying asleep, and/or waking up too early. Sometimes these difficulties can come and go in episodes, while other times, they can persist in long stretches, no matter how much opportunity or desire they have to sleep. Over time, a person can feel very worn down and struggle to function.
But, there is no reason for me not to sleep, I just can’t.
There does not need to be an identifiable “reason,” such as a triggering event, depression, or anxiety, for a person to experience insomnia. For diagnosis, it only matters that a person isn’t satisfied with their sleep for a certain period of time, that they feel impaired in important aspects of functioning (e.g. work, school), and that the sleep issues are not from substances or other medical issues. That said, insomnia is recognized and treated in the mental health community because there are likely some unhelpful behaviors and negative thoughts that develop around sleep (or the lack thereof), which maintain the insomnia. In short, when people can’t sleep well, they tend to worry about not sleeping, which makes them want to sleep more. Paradoxically, the more pressure we put on sleeping, the more difficult it can be to sleep.
Healthy Sleep
In attempts to resolve the problem, people often develop poor habits surrounding sleep and find themselves more and more dependent on medication and other temporary supports for sleep. While medications and supports, such as naps, may help in the short term, they do not resolve the underlying issue. As the insomnia returns or worsens and medications become less effective, the more the worries creep in. People often worry about “never sleeping again” or tell themselves that to be healthy, they “should” be sleeping a certain number of hours.
Cognitive behavioral therapy for insomnia (CBT-I) is a time-limited, evidence-based treatment for insomnia that teaches skills for making necessary behavioral changes for sleep, for evaluating thoughts related to sleep, and for relaxation. By learning the necessary skills, CBT-I establishes helpful sleep habits and management of negative thoughts or worries surrounding sleep (or lack thereof) that typically maintain a bout of insomnia. Research shows that CBT-I is an effective, brief intervention with lasting results with most people finding relief in about 6 sessions, depending on severity and patient participation.