Cognitive Behavioral Therapy for Insomnia (CBT-i)

Do you have trouble getting quality sleep, such as waking up, still feeling exhausted, or worry about not being able to fall asleep? You’re not alone, and sleep therapy can help you get restorative sleep again.

woman sleeping peacefully without insomnia
Better sleep is possible.

What is insomnia?

A third of Canadian adults struggle to get sufficient, good-quality sleep night after night. Current research suggests that insomnia is a growing worldwide trend. Therapy for sleep troubles is considered the most effective first-line treatment for insomnia over sleeping medications in the long term.

In my practice, I offer behavioural sleep therapy as it can significantly improve your overall sense of well-being. Imagine spending less time feeling exhausted and focusing more on what matters most.

Insomnia is the most common sleep disorder characterized by:

  • Difficulty falling asleep
  • Staying asleep,
  • Waking up too early,
  • Not being able to return to sleep. 

If symptoms persist for more than three months, it is considered chronic insomnia. Insomnia harms your health, increasing your risk of depression, anxiety, and high blood pressure. It also lowers your quality of life and has long-term impacts on your physical, emotional, and mental health.

Common symptoms of insomnia include:

  • Fatigue
  • Inability to focus or concentrate
  • Poor memory
  • Mood disturbance
  • Daytime sleepiness
  • Low motivation or energy
  • Increased errors or accidents

Insomnia also can keep you from performing your best at work and school. A study from Quebec, Canada, found that workers with insomnia had a significantly increased risk for concurrent health problems and workplace injuries.

In the same study, researchers found that these individuals were likelier to use health care services, miss work, and experience a drop in productivity. Similarly, an American study from 2011 estimated that an employee with insomnia loses nearly eight days of work each year due to sleep-related difficulties.

CBT-I: Evidence-based sleep and insomnia therapy

The American College of Physicians and the American Academy of Sleep Medicine recommend Cognitive Behavioral Therapy for insomnia (CBT-I) as the first line of treatment for insomnia. Numerous randomized control trials have demonstrated its effectiveness compared to prescription sleep medication and sleep hygiene education alone.

CBT-I is a structured therapy that involves working with a therapist on shifting your environment, attitudes, beliefs and behaviours that harm your sleep quality.

The positive effects of CBT-I can be long-lasting and often preferable to taking sleep medications or sleep aids long-term. Many sleep aids are ineffective or only useful in the short term and can carry severe side effects.

Cognitive Behavioral Therapy for insomnia can benefit nearly anyone with sleep problems, including people who are struggling with physical issues, such as chronic pain, or mental health concerns, such as depression and anxiety.

What does CBT-I treatment involve?

Over 5-6 weekly sessions, delivered online to anyone in British Columbia or Ontario (from Vancouver to Toronto), we will address sleep habits, structure, negative thoughts and beliefs about sleep and insomnia. If you live outside these provinces, you might benefit from my self-paced Sleep Program with Sleep Coaching Support.

We also comprehensively review other issues that might be contributing to your sleep difficulties. These actions include:

  • Sleep journal:
    CBT-I relies on capturing sleep and wake times with an app or pen and paper to track the data required to provide feedback on your sleep and organize your sleep schedule.
  • Sleep hygiene:
    Behaviours and routines help you get quality sleep that leaves you feeling refreshed and alert during the day.
  • Sleep restriction or sleep compression:
    Limit time in bed to increase sleep efficiency and allow sleep to become deeper and more consolidated. The goal is to work towards uninterrupted chunks of sleep rather than broken-up sleep).
  • Stimulus control:
    Break negative associations with the sleep environment and bedtime routines.
  • Cognitive restructuring:
    Challenge unhelpful automatic thoughts (cognitive distortions), and manage racing thoughts that undermine your ability to get good sleep.
  • Relaxation and mindfulness strategies
    Develop a practical toolbox of effective strategies to help you unwind well before bed.

Clinical studies have demonstrated that CBT-I is an effective treatment for insomnia and can improve overall sleep quality, daytime functioning and performance (such as your ability to concentrate and stay alert). Better quality sleep can also reduce the overall intensity of mood symptoms, such as depression and anxiety.

Most importantly, you are more likely to maintain the gains over the long term, which can help you reduce the overall reliance on medication and other substances used for sleep, such as alcohol and cannabis.

Why work with a sleep therapist?

Chances are you are already aware of the many elements of good sleep, also called sleep hygiene. And there are many great books and resources to help you improve your sleep on your own. I offer expert assessment, guidance, and support. Also, I can help you address other emotional and psychological issues that may impact your sleep.

We will work through a research-backed, cost-effective, and structured insomnia treatment that is safer than medication and customized to your specific needs, history, and strengths.

The ultimate goal is to help you sleep better, wake up feeling refreshed (more often than not), and have the energy to focus on getting the most out of your day. That’s why I firmly believe that good nights lead to better days.

How much does it cost?

I offer Cognitive Behavioral Therapy for sleep and insomnia over five to six sessions online from my office in Downtown Vancouver. Please see my Fees page or connect with me for more information.

How to get started with sleep therapy?

  1. Take the brief Insomnia Self-Test for a general sleep assessment (please note this is not a diagnostic tool)
  2. Please connect with your primary health care provider for an assessment and diagnosis if you are experiencing sleep health problems other than insomnia, such as sleep apnea and restless legs syndrome.
  3. Connect with me for a no-cost initial consultation to see if CBT-I, supported by a sleep therapist, is a good fit for you. Through Quadra Wellness and Counselling, I offer CBT-I therapy sessions online, which offers a secure, convenient way to get your sleep back on track.