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For some people it's time on the computer that causes their sleep deprivation, but for others a computer-based intervention can be the key to normalizing their sleep cycles.

Some people who have insomnia just can't fall asleep. For them, beating their sleep disorder can be as simple as avoiding distractions when they are getting ready for bed and remembering that if you have insomnia, coffee is a no-no at bedtime.

Other people who have insomnia are unusually sensitive to blue light, the natural rays of the sunrise. Blue light is great in the early morning when you want to be up and around, but it has to be blocked from the bedroom for good sleep.

And some insomniacs can't sleep because of something doctors call a sleep maintenance disorder. When their head hits the pillow, they are so tired that it's lights out. After a few hours, however, they wake up in the middle of the night and can't get back to sleep, so that they are constantly sleep-deprived and tired all the time.

For treating sleep-maintenance disorders, modern medicine has a new prescription: Think happy thoughts. To help people avoid the negative thinking that can keep them awake, there is now cognitive behavioral therapy for insomnia or C.B.T.-I. Many doctors recommend it as the first thing that should be tried, even before sleep medication.

What Is C.B.T.-I.?

Cognitive therapy is a form of psychotherapy in which negative thoughts about self and world are challenged to alter unwanted patterns of thinking and doing. Cognitive behavioral therapy is specifically a form of psychotherapy that aims to change unwanted behaviors, such as getting up in the middle of the night. Cognitive behavior therapy for insomnia is targeted at stopping the behaviors that interfere with sleep.

Cognitive behavioral therapy for insomnia helps people avoid getting up too early. Oddly enough, like the little engine that made it up the hill saying "I think I can, I think I can, I think I can," when people think they can get a full night's sleep, they actually can. 

C.B.T.-I. isn't like taking a sleeping pill. It doesn't "knock you out." It doesn't work perfectly.

  • Instead of waking up too early every morning, you might wake up too early just one day a week.
  • Instead of taking half an hour to get to sleep, you might only need 10 minutes.
  • Instead of being awake for a couple of hours when you wake up in the middle of the night, you might only stay awake for one hour.

This method isn't a miracle, but it doesn't have serious side effects, either. There is no next day hangover from C.B.T.-I.

Therapist or Computer-Based Program?

Since cognitive behavioral therapy for insomnia is a form of psychotherapy, ordinarily it is something you would get from a psychotherapist. The problem is that psychotherapy is not inexpensive, and there are limits for insurance coverage. Access to treatment is further complicated by the fact that relatively few psychotherapists have been trained in the technique.

With computer-based C.B.T.-I., there is still feedback (after all, you can report your success face-to-face to a psychotherapist or to yourself on a computer). There's no need to schedule an appointment and make a trip to the therapist's office. The method is available any time and anywhere. And the cost of treatment is low. The questions are how do you access the therapy, and does it really work?

Continue reading after recommendations

  • Eidelman P, Talbot L, Ivers H, Bélanger L, Morin CM, Harvey AG. Change in Dysfunctional Beliefs About Sleep in Behavior Therapy, Cognitive Therapy, and Cognitive-Behavioral Therapy for Insomnia. Behav Ther. 2016 Jan. 47(1):102-15. doi: 10.1016/j.beth.2015.10.002. PMID: 26763501.
  • Lovato N, Lack L, Wright H, Kennaway DJ. Predictors of improvement in subjective sleep quality reported by older adults following group-based cognitive behavior therapy for sleep maintenance and early morning awakening insomnia. Sleep Med. 2013 Sep. 14(9):888-93. doi: 10.1016/j.sleep.2013.05.008. PMID: 23871260.
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