Sleep Disorders

Cognitive Behavioural Therapy (CBT) is recognised as a highly effective non-pharmacological treatment for Sleep Disorders, particularly insomnia. Insomnia, which involves difficulty falling asleep, staying asleep, or waking up too early and not being able to return to sleep, can significantly impact a person's quality of life, leading to anxiety, distress, daytime fatigue and mood disturbances.

 

CBT for insomnia (CBT-I) specifically targets the thoughts, feelings, and behaviours that contribute to sleep disturbances. The treatment addresses the cognitive and behavioural components of sleep, focusing on breaking the cycle of anxiety and frustration that often accompanies insomnia.

 

One of the key cognitive aspects of CBT-I is tackling the dysfunctional beliefs and worries about sleep that many individuals with insomnia experience. People often ruminate over their inability to sleep and worry about the consequences of sleep loss, which in turn can increase sleep-related anxiety. This anxiety is then associated with increased arousal which makes sleep more difficult. Through cognitive restructuring, CBT-I helps individuals identify and challenge these negative thoughts and beliefs.

 

Behavioural strategies are also central to CBT-I. These include techniques like stimulus control, which aims to help the person see bed as a cue for sleep rather than for wakefulness. Another technique, sleep restriction therapy, involves limiting the amount of time spent in bed to closely match the actual sleep time, thereby increasing sleep efficiency.

 

CBT-I also incorporates relaxation and mindfulness techniques and sleep education. Relaxation methods such as mindful breathing exercises can reduce physical and mental arousal at bedtime. Sleep hygiene education focuses on optimising the sleep environment and habits that promote consistent, uninterrupted sleep. This includes may include maintaining a regular sleep schedule, creating a comfortable sleep environment, and avoiding stimulants and electronic screens before bedtime.

 

CBT-I has been shown to be very effective, with many individuals experiencing significant improvements in sleep quality, duration, and onset. Studies have shown that the benefits of CBT-I are sustainable over the long term, making it a preferred choice for managing insomnia without medication. By addressing the underlying cognitive and behavioural aspects of sleep disturbance, CBT-I empowers individuals to improve their sleep patterns and, as a result, enhances their overall health and wellbeing.

 

Other sleep difficulties that are treatable by cognitive behavioural therapy include adjusting to CPAP treatment for Obstructive Sleep Apnoea; persistent nightmares; night terrors (waking with anxiety without a nightmare); sleep paralysis and hypersomnia.

 

Gus has had a longstanding interest and extensive experience in the psychological treatment of sleep difficulties. He has worked with Sleep Disorders for many years through his work with the St George Hospital’s Sleep Disorders Unit where he currently runs a clinic, as well as his longstanding collaborative relationships with many Sleep Specialists.