Cognitive Behavioral Therapy for Insomnia (CBT-I)

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Occupational therapists can consider intervention for sleep disturbances with cognitive behavior therapy (CBT). CBT focuses on modifying unhealthy sleep habits, decreasing autonomic and cognitive arousals, altering negative beliefs and attitudes about sleep, and educating patients about sleep hygiene. Research has supported the use of CBT as a nonpharmacologic treatment to sleep disturbance.

Cognitive Behavioral Therapy for Insomnia (CBT-I) is often considered the first-line, gold standard treatment for insomnia. CBT-I is recognized by the NIH and found to be as effective as medication for the treatment of insomnia. CBT-I may work better than sleep medications, has no side effects, and is a more affordable long-term treatment. Improvements can be seen after 4 weeks. Approximately 80% of CBT-I participants report significant long-term sleep improvement.

CBT-i can be completed without the use of sleeping medications.

It is important to rule out other causes of insomnia such as:

  • Sleep apnea
  • Restless leg syndrome
  • Periodic limb movement disorder
  • Narcolepsy
  • Circadian rhythm disorders

What CBT-I is:

  • Hard work
  • Requires commitment
  • Takes practice
  • Aims to increase the amount of time and quality of sleep

CBT-I Components

  1. Sleep restriction
  2. Stimulus control
  3. Cognitive therapy
  4. Sleep hygiene
  5. Relaxation training