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Cognitive Behavioral Therapy for Insomnia (CBT-i)

Do you have trouble getting quality sleep? Wake up still feeling exhausted or worry about not being able to fall asleep? You’re not alone and sleep therapy can help.

Getting sufficient, good quality sleep night after night is a struggle for a third of Canadian adults and 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.

I offer and integrate behavioral sleep therapy into my practice as it can significantly improve your overall well being, so you can spend less time feeling exhausted and more time focused on what matters most to you.

Insomnia is the most common sleep disorder characterized by difficulty falling asleep, staying asleep, or waking up too early, and not being able to return to sleep at least three nights per week. If symptoms persist for more than three months, it is considered chronic insomnia.

Insomnia has a negative impact on 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.

The researchers also found that these individuals were more likely 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 about nearly eight days of work each year due to sleep related difficulties.

CBT-i: Evidence-based sleep and insomnia therapy

Cognitive Behavioral Therapy for insomnia (CBT-i) is recommended by the American College of Physicians and American Academy Sleep Medicine as the first line of treatment for chronic insomnia. It’s effectiveness has been demonstrated by numerous randomized control trials in comparison to prescription sleep medication and/or sleep hygiene education alone.

CBT-i is a structured therapy that involves working with a therapist on shifting your environment, attitudes, beliefs and behaviors that have a negative impact on your sleep.

The positive effects of CBT-i can be long-lasting and often preferable to taking sleep medications or sleep aids long term, which are ineffective or only effective in the short term and can have serious side effects.

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

What is does CBT-i treatment involve?

Over 5-6 weekly sessions (either online or in-person at my office in Downtown Vancouver), we will work on addressing sleep habits, sleep structure, as well as negative thoughts and beliefs about sleep, insomnia, and 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 that help you have quality sleep and feel fresh and alert during the day.
     
  • Sleep restriction:
    Limit time in bed in order to increase sleep efficiency and allow sleep to become deeper and more consolidated (this means getting your sleep in one chunk, rather than broken up)
     
  • Stimulus control:
    Break negative associations with the sleep environment and bedtime routines.
     
  • Cognitive restructuring:
    Challenge unhelpful automatic thoughts (also called cognitive distortions), and manage racing thoughts that undermine your ability to get good sleep.
     
  • Relaxation strategies
    Develop an effective toolbox of strategies to help you unwind before bed

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

In addition, you are more likely to maintain the gains over the long term and can help you reduce 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, in addition to being able to help you address other emotional issues that may be impacting 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 and history.

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

How much does it cost?

I offer CBT-i at a reduced rate for 5 – 50 minute online sessions and my standard rate for in-person sleep therapy at 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. If you are experiencing other sleep health problems (such as sleep apnea or restless legs syndrome), or have not been diagnosed as having insomnia by a qualified health care professional, please connect with your primary health care provider for a proper assessment and diagnosis.
     
  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, both in-person and online.