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Sleep & Insomnia

Image by Jp Valery

Image by Jp Valery

Cognitive-Behavioral Therapy for Insomnia, or CBT-I, is treatment for insomnia disorder, not for any sleep disorder. We would want to rule out another sleep disorder like sleep-disordered breathing (like sleep apnea), movement-related sleep disorder (like restless legs syndrome), or excessive daytime sleepiness (involuntarily falling asleep). You might have to follow up with your Primary Care Provider for a medical work-up and/or possible referral to a sleep center.


Signs of insomnia can include:

  • Problems falling asleep – can take a long time to get to sleep - seems like an eternity

  • Problems staying asleep – waking up many times in the middle of the night

  • Problems waking up too early – say at 4 AM instead of the desired 6 AM and can’t fall back asleep

  • Not feeling well-refreshed after waking up

  • Having a hard time functioning and/or feeling distressed about sleep (or not sleeping)

  • Ongoing for a while, say at least 3 months – not just short-term or short-lived

If you’ve been having problems sleeping for a long time, you’ve probably already tried many over-the-counter and prescription medications with mixed results. You want to get sleep in a natural way. We can work on that together in Cognitive-Behavioral Therapy for Insomnia.


First we would do an intake/assessment/consultation to discuss your sleep. You would keep a sleep log/diary for your baseline and also throughout your treatment to help us track any changes in your sleep. Every 1-2 weeks, we would review your sleep log/diary results and talk about changes you can make to improve sleep. I’d estimate typically 4-6 sessions for our treatment.


The main tools for our treatment are a) stimulus control (strengthening the connection between bed and sleep) and b) sleep restriction, or I’d rather call it sleep consolidation (maximizing how much of the time you’re actually asleep when you’re in bed). We can add other tools as needed, such as relaxation or cognitive reframing or rebalancing. Goal is for you to get better sleep! Treatment that works. By the way, "cognitive" is how we think about sleep, and "behavioral" is what we do around sleep.


Resource: What is CBT-I? (Society of Behavioral Sleep Medicine)


To schedule a free 15-minute phone chat with me to talk about your sleep problems, call me at (253)783-9367 or email me at

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