CBT-I and Sleep Hygiene- activities, instructions and techniques
Today, we'll take a look at Cognitive Behavioral Therapy for Insomnia, CBT-I, as it relates to sleep hygiene, one of the most popular topics within the treatment approach.
Living with insomnia can be challenging. The good news is that there are many effective treatments available that can help you fall asleep faster, stay asleep longer, and feel more energized throughout the day. One such treatment that’s gained a lot of traction is CBT-I or cognitive behavioral therapy for insomnia. This short, structured program is backed by evidence and, when used in combination with other treatments, is shown to be effective. Today, we’ll take a look at CBT-I as it relates to sleep hygiene, one of the most popular topics within the treatment approach.
What is Sleep Hygiene?
One of the main premises behind CBT-I is teaching sleep education, which includes educating on the topic of sleep hygiene. As you may know, your behaviors can influence how soundly you sleep. Once you understand this, it becomes much easier to improve your sleep patterns. So, when it comes to sleep hygiene, CBT-I will teach you about poor sleep hygiene, which basically means that you could be making decisions that affect your sleep for the worse.
The American Academy of Sleep Medicine (AASM) defines sleep hygiene as basic tips and habits that can be used to develop healthy sleep patterns. However, since sleep disturbances are often caused by more than one action, according to CBT-I, you must change every bad habit if you wish to improve your sleep.
That said, here are the basics of sleep hygiene:
Maintain a Regular Schedule
Going to bed and waking up at the same time helps regulate your natural circadian rhythm. Setting a regular schedule allows you to train your body and mind on what to expect each day. Thus, you’ll begin getting tired as your bedtime nears.
The idea of ‘wind down’ time before bed is promoted during CBT-I. This usually means setting aside 20 to 30 minutes before you go to bed, where you don’t watch TV or use your phone, as these activities can keep you awake at night.
It’s recommended that this time is used for promoting relaxation, such as practicing mindfulness, listening to an audiobook, stretching gently, or soaking in a bath.
Renovate Your Bedroom Environment
Most people don’t realize that their bedroom environment plays a crucial role in how well they sleep. During CBT-I, you’re taught to associate your bedroom with sleep, sex, and relaxation only. This helps your brain make an association with relaxation, which can help with sleep.
With this, most experts suggest you aim to make your bedroom comfortable. Begin with simple tasks like ensuring your mattress and bed are comfy, add pillows or a mattress topper, and use a cozy blanket. Yet, another crucial part of this is keeping your bedroom at a suitable temperature. According to the National Sleep Foundation, the optimal temperature is around 65 degrees Fahrenheit.
Moreover, since your body uses light to determine your circadian rhythm, keeping your bedroom dark is vital. This is easily accomplished by adding blackout curtains, wearing an eye mask, or installing dimmer lighting. Lastly, bedroom noise is also important. As you know, loud noises can make it impossible to sleep, so if you can’t rid your bedroom of noise, you may want to buy earplugs.
Breaking Bad Habits Such as Drinking and Eating Before Bed
What you drink and eat before bed significantly impacts your quality of sleep. For example, eating large meals too close to bedtime can give you indigestion and make you uncomfortable and bloated.
Alternatively, going to bed hungry can make it a struggle to fall asleep. Combat these problems by eating larger meals earlier and then having a small snack before bed. You should also avoid other stimulants such as caffeine, nicotine, and alcohol, which can keep you awake when used too close to bedtime.
Sure short naps can help boost your energy, concentration, or mood, but if you struggle to sleep at night, napping during the day can be detrimental. In fact, according to CBT-I, napping can make you feel less tired at night and confuse your sleep-wake cycles. Hence, it’s best to limit or avoid naps altogether.
Adding exercise to your day offers many benefits, including better quality sleep. When you exercise, you tire your body and mind in a healthy way, making you ready for sleep when you go to bed. And let’s not forget that daily exercise helps lessen stress and improves relationships, which can positively affect sleep.
Does Sleep Hygiene Work for Insomnia?
According to the AASM, sleep hygiene is effective when used in combination with other CBT-I methods. In other words, sleep hygiene is not a sufficient treatment for insomnia when it’s used as a single-component treatment.
The truth is that CBT-I is much more than just sleep hygiene. This treatment process is considered a multi-component treatment because it combines different approaches that include behavioral, cognitive, and educational components. So, rather than just focusing on sleep hygiene, CBT-I covers other topics such as:
- Cognitive restructuring
- Stimulus control
- Sleep restriction and compression
- Relaxation technique training
- Habit building
Hence, when used in combination as a multi-component system, CBT-I is effective for up to 80 percent of patients with insomnia. So, after a person has completed the treatment, they should notice that they fall asleep faster, spend more time sleeping, and wake up fewer times during the night. Though, as studies point out, this process takes time and requires maintenance.
The American College of Physicians recommends that all adults receive CBT-I as an initial approach, as it’s more effective than medication for some patients. Moreover, this treatment is excellent for groups who are at a higher risk of developing insomnia, such as those with post-traumatic stress disorder, who have undergone cancer treatments, or who are pregnant.
CBT-I is accepted as an effective treatment for many types of insomnia, even benefiting those with short-term insomnia. This means that CBT-I can be useful for treating symptoms that cannot be diagnosed as chronic insomnia. While this treatment is highly effective, we should note that it may not work instantly because techniques like sleep restriction and stimulus control take time to master.
Ultimately, if you are suffering from insomnia, CBT-I is a great treatment option. And while sleep hygiene is a key component in this treatment, it’s not usually effective on its own. If you’d like to learn more about treatment options for your insomnia, take our free sleep quiz today!