Insomnia Treatment
Why can’t I sleep at night?
Is it hard to fall asleep even when you try your best?
Do you often wake up at 2, 3 or 4 a.m.?
Do you go to bed tired only to then feel wide awake?
“I’m an insomniac, my mind works the night shift.”
- Pete Wentz, Musician, Singer, and Songwriter
Well, if this happens to you, then you and Pete are in the company of many who have the same problem. World-Wide 10 to 30 percent¹ of us are trying extremely hard to sleep with our nights often ending with only a few hours or less of restorative sleep. The frustration and endless effort are exhausting mentally and physically. In the United States, 50-70 million adults report some type of sleeping disorder including short-term insomnia. As many as 10 percent of adults in the U.S. report chronic insomnia². Specifically, in Arkansas 37.6 percent of adults report sleeping less than the recommended 7-8 hours of sleep³.
During the Covid-19 outbreak, sleep problems among all populations globally increased to 35.7 percent⁴. Not surprisingly, Google searches for insomnia in the United States from January-May of 2020 increased by 58 percent, which totaled over two million searches⁵.
What’s going on? Why can’t I sleep?
Your inability to sleep is definitely not because of your lack of effort. The physical mechanisms responsible for good sleep are your Circadian Rhythm or body clock and Homeostatic or sleep drive. When your sleep drive builds throughout the day and your body clock registers the decreased amount of exposed light then your wake and sleep cycle provide you with a restful night of sleep. However, if your bedtime and waketime is irregular, or you have been inactive, and/or you’re experiencing above normal arousal (hyperarousal), then these factors can precipitate insomnia⁶.
How do I know if I have insomnia?
That’s a good question because there is a difference between insomnia and just a few sleepless nights. You’ll know you have insomnia when you complete an Insomnia assessment, which keys in on several different areas of sleep, such as difficulty falling asleep, staying asleep, and/or waking up earlier than you planned. If you’ve been unable to sleep for at least 6-7 hours of restorative sleep for most days per week for several weeks, it’s time you seek help.
You may be asking, what caused my sleep drive and body clock to mess up?
It could be any number of things like maybe you worked night shift for a while, or you had a baby, or you’ve had multiple late nights studying for college exams or courses. Sometimes, insomnia can be caused by moderate to severe anxiety, nightmares, fears of sleep, depression, or an increase in distress due to a past trauma. Medical conditions such as fibromyalgia, Parkinson’s Disease and other illnesses or conditions can cause insomnia. For women, menopause is often a significant cause for insomnia. The great news is that insomnia is not a life-sentence, and there is a proven and effective treatment to deal with the problems of insomnia and have refreshing sleep. I can help you.
How can I improve my sleep without medication?
“Nothing cures insomnia like the realization that it’s time to get up.”
- Author Unknown
What makes CBT-I the frontline treatment for insomnia?
Both the American Academy of Sleep Medicine and the American College of Physicians recommend CBT-I as the “gold standard” of treatment⁷. CBT-I is an individualized method that keys on the areas that you need to be treated either behaviorally and/or altering thoughts. We all know the side effects of many sleep-inducing medications, and this is one of the reasons physicians and medical practitioners present CBT-I as an effective option⁸. Multiple research studies have found CBT-I to be an evidence-based treatment that includes many components. You will learn the importance of relaxation training, and you will be encouraged to practice this daily. You will understand that you must associate your bed with only two activities: sleep and sex. That’s right, you’ll learn that to watch TV, play games on your phone, texting on your phone, or worrying about bills must be completed somewhere other than your bed. You’ll learn information about sleep in general and explore myths about sleep. This treatment is based on Cognitive Behavior Therapy, which aligns well in treating individuals with both insomnia and other mental health conditions, such as anxiety, PTSD, and depression⁹.
What might a first session for insomnia look like?
I am trained in Cognitive Behavior Therapy for Insomnia, and I want to help you develop an individualized plan to help you have the quality of sleep that feels restful and refreshing for you. At your first session, you will complete an Insomnia assessment. I will provide information about sleep and explain the process beginning with a detailed sleep-diary. This is where your commitment, dedication, and effort to improving your sleep will be invaluable to your treatment. From there, we will work together to find the best techniques to help in your situation. You will be given a sleep prescription to follow. The goal is for you to have improved refreshing sleep.
(If) You watch “The Walking Dead” and find yourself sympathizing with the walkers (you may have insomnia)¹⁰.
How many sessions will this take?
You may be asking yourself how many sessions will it take for me to notice improved sleep? After you receive your prescription for sleep, you will most likely notice improvement in your sleep in as little as two weeks. Typically, I tell people improvements in sleep can be noted within six sessions. There are factors involved that may delay the results, such as your involvement in your treatment, consistency with following the prescribed sleep regimen, and if there are any underlying issues, such as relationship problems, depression, anxiety, and/or PTSD. The good news is I can help you address these as well!
How do I start?
You’re first step is to contact me. I know it can be challenging to start something new and committing to the time and effort is often a struggle. I understand and will strive to make this challenge as comfortable and worthwhile as possible. I offer a free phone consultation up to 20 minutes. You can contact me to set up a phone conversation, and we’ll see if we can form a team to focus on improving your sleep. Your health, relationships, and all the things you enjoy deserve your best, and this often begins with a good night’s sleep. You can reach me at 479-531-9844, email me at twilaowens.lcsw@clarity-hope.com, fill out the contact form on my website, or you can find me through Psychology Today.
¹ Bhaskar, S., Hemavathy, D., & Prasad, S. (2016). Prevalence of chronic insomnia in adult patients and its correlation with medical comorbidities. Journal of family medicine and primary care, 5(4), 780–784. https://doi.org/10.4103/2249-4863.201153
² American Sleep Association. Sleep and Sleep Disorder Statistics.
https://www.sleepassociation.org/about-sleep/sleep-statistics/
³ National Center for Chronic Disease Prevention and Health Promotion. (2016, November). Sleep and Health Among Adults in Arkansas. https://www.cdc.gov/sleep
⁴ Jahrami, H., BaHammam, A.S., Bragazzi, N.L., Said, Z., Faris, M., & Vitiello, M.V. (2021). Sleep problems during the COVID-19 pandemic by population: a systematic review and meta-analysis. Journal of Clinical Sleep Medicine, 17 (2), 299-313. [American Academy of Sleep Medicine] [https://doi.org/10.5664/jcsm.8930]
⁵ Science Daily. (2020, November 18). Web searches for insomnia surged at heigh of COVID-19 stay-at-home orders. https://www.sciencedaily.com/releases/2020/11/201118141724.htm
⁶ Carney, C.E. Danforth, M. (2018) 3-Day Certificate Course: Cognitive Behavior Therapy for Insomnia (CBT-I). [Power Point, Sleep Regulation]. PESI, Inc.
⁷ CONTINUUM (MINNEAP MINN) 2020; 26(4, SLEEP NEUROLOGY): 1003-1015
⁸ Mayo Clinic. Mayo Foundation for Medical Education and Research. (1998-2021). Insomnia.
http://www.mayoclinic.org/diseases-conditions/insomnia/diagnosis-treatment/drc-20355173?p=1
⁹ Wu, J.Q., Appleman, E.R., Salazar, R.D., Ong, J.C. Cognitive Behavior Therapy for Insomnia Comorbid with Psychiatric and Medical Conditions A Meta-Analysis. JAMA Internal Medicine 2015, September; 175 (9): 1461-1472
file:///C:/Users/btowe/Downloads/ioi150058%20(1).pdf
Downloaded From: https://jamanetwork.com/ on 05/02/2021
¹⁰ Soetendorp, J. 29 Things Only Someone with Insomnia Would Understand. Healthline 2017, October 15
https://www.healthline.com/health/insomnia/would-understand