Why Sleep Therapy?
Dr. Detweiler-Bedell offers the first-line insomnia treatment: Cognitive Behavioral Therapy for Insomnia (CBT-I). The American Academy of Sleep Medicine and the American College of Physicians recommend all adult patients receive CBT-I as the initial treatment for chronic insomnia, not only because of its well-documented effectiveness but also because the effects of this type of sleep therapy are long-lasting.
How does CBT-I work?
CBT-I begins with an initial assessment of your sleep, followed by 4 to 6 individual therapy sessions. With insomnia treatment, you will learn how to increase your body’s natural sleep drive, adjust your internal sleep/wake clock, and feel calm and relaxed in bed.
This is accomplished, first, by becoming your own sleep scientist and keeping track of the time you spend in bed and the amount of time you sleep each night. With this information in hand, your therapist will work closely with you in order to identify how much time to spend in bed and the appropriate bedtime and wake-up time for you.
What will you experience?
Making changes to your sleep schedule, along with learning when to stop trying to sleep, are the behavioral components of CBT-I. The cognitive components of CBT-I refer to the thoughts you have about your sleep, the worries that keep you awake, and the perception that your bed is a stressful place.
Dr. Detweiler-Bedell will teach you helpful strategies to manage thoughts that interfere with your ability to fall asleep easily. And you may learn some new relaxation strategies, ways to make your sleep environment more comfortable, and ways to sustain habits that positively influence your sleep.
What can you expect?
Most people experience significant improvements in their sleep within four insomnia treatment sessions, which are scheduled every other week. The benefits of CBT-I as described by the Society for Behavioral Sleep Medicine include:
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Treatment is short-term (typically 4 to 6 sessions).
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Treatment benefits are long-lasting (a 2022 study shows sustained benefits 10 years after treatment).
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Improvements are as good as or better than medications, without the side effects.
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CBT-I can be used to treat insomnia co-occurring with many other medical and psychological diagnoses.
What About Sleep Medications?
Research demonstrates that CBT-I works at least as well as prescription sleep medications, and it has the added benefit of fewer negative effects during insomnia treatment. The American College of Physicians recommends CBT-I over medication, because “it is noninvasive, its effects are durable, and it avoids the adverse side effects associated with medications used to induce sleep.” If you are already taking sleep medications, Dr. Detweiler-Bedell can work with you and your physician to determine how CBT-I can be offered as an addition to or a gradual replacement of your sleep medication use.
For more information, see the insomnia treatment overview written by the Mayo Clinic Staff and see the Association for Behavioral and Cognitive Therapies insomnia factsheet.