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Cognitive Behavioral Treatments for Sleep Problems

Lifestyle modifications and cognitive behavioral treatments for sleep problems may include:

  • Relaxation training
  • Cognitive therapy
  • Stimulus control (SC)
  • Sleep restriction therapy (SRT)
  • Sleep hygiene

 

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Brian Cyphers has always had trouble falling asleep at a "normal" hour. A few years ago, when the 24-year-old Chicagoan was dozing off between 3 and 5 in the morning and had to wake up at 6:30 to get to his job as a data entry clerk at a lab, he knew it was time to seek help. Cyphers sought assistance from Lisa Shives, MD, medical director of Northshore Sleep Medicine in Evanston, Ill., and a specialist in sleep disorders. Shives frequently sees patients who want to alter their night owl ways. "People...

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Relaxation Training for Sleep Disorders

Methods such as progressive muscle relaxation (PMR), deep breathing techniques, imagery, and self-hypnosis may help some people overcome a sleep disorder. PMR involves helping the individual to sequentially tense and relax the body's major muscle groups while concentrating on contrasting sensations of tension and relaxation. 

Cognitive Therapy for Sleep Disorders

Cognitive therapy helps people with insomnia identify and correct inappropriate thoughts and beliefs that may contribute to insomnia. Cognitive therapy can give people the proper information about sleep norms, age-related sleep changes, reasonable sleep goals, and the influence of naps and exercise.

Stimulus Control for Sleep Disorders

Stimulus control (SC) is a practice in which the bedroom is reserved for sleep and sex. SC derives from the idea that insomnia may be caused by bedroom associations unrelated to those uses, such as stressful situations, or TV watching. Therefore, the bedroom should be reserved for sleep, sex, and dressing only.

Sleep Restriction Therapy for Sleep Disorders

Sleep restriction therapy (SRT) is based on the belief that excess time in bed makes sleep problems worse. SRT consists of limiting a person's time in bed to only that time where they are sleeping.

Sleep Hygiene for Sleep Disorders

Sleep hygiene refers to practices, habits, and environmental factors that are important for getting sound sleep. The four general areas important to sleep hygiene are the circadian rhythm (24-hour cycle), aging, psychological stressors that cause mini-awakenings (in which the brain wakes up for just a few seconds), and stimulant use.

  • Circadian rhythms influence when, how much, and how well people sleep. These rhythms may be altered by the timing of various factors, including naps, bedtime, exercise, and exposure to light.
  • Aging also plays a role in sleep. Sleep patterns change after people reach the age of 40. There are many more nocturnal awakenings as people age. The awakenings affect sleep quality and can interact with any other condition that may cause arousals or awakenings. The more awakenings people experience at night, the more likely they will awaken with a feeling of not being rested.
  • Psychological stressors such as exams, deadlines, or job stress may interfere with sleep. It is beneficial for people to develop some kind of pre-sleep ritual to break the connection between stress and bedtime. Some people find it helpful to make a list of all the stressors of the day, along with a plan to deal with them. In addition, periods of relaxation (meditating or taking a hot bath) can help a person relax and get to sleep.
  • Stimulants can stay in the body as long as 14 hours and can increase the number of times you awaken at night, decreasing your total amount of sleep time. Avoid caffeine, nicotine, and alcohol. The effects of nicotine, when consumed in high doses, are similar to those of caffeine. Alcohol may initially sedate you, making it easier to fall asleep. The downside to alcohol is that as it is metabolized and cleared from your system during sleep, it causes arousals that can last as long as two to three hours after it has been eliminated.


 

 

WebMD Medical Reference

Reviewed by Louis R. Chanin, MD on July 31, 2012

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You say you are able to function well with fewer than seven hours of sleep. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

Since you usually get too little sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have insomnia or other conditions affecting your sleep.

Sleep deprivation can have both short- and long-term consequences. Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's not surprising you feel that you're not functioning at your best today. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

Since you usually get too little sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have difficulty sleeping, have insomnia, or have other sleep disorders.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's not surprising you feel that you're not functioning at your best today. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

It's good that you usually do get more sleep, since sleep deprivation can have both short- and long-term consequences. Learn more about the health consequences of sleep loss. And if you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

You say you are able to function well with fewer than seven hours of sleep. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

It's good that you usually do get more sleep because sleep deprivation can have both short- and long-term consequences. Learn more about the health consequences of sleep loss. And if you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's not surprising you feel that you're not functioning at your best today. Some people say they can function on four to six hours of sleep each night, but research shows that adults who get fewer than seven hours of sleep — whether for just one night or over the course of days, weeks, or months — have more difficulty concentrating and more mood problems than people who sleep seven to nine hours.

Since you usually get less sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have difficulty sleeping or have insomnia or other sleep disorders.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's wonderful that you got a good night's sleep last night. Many people struggle to do so. Having a good sleep routine often is the key to getting the quality sleep night after night that your body needs for optimal health. Whether your sleep routine involves taking a warm bath, reading a book, or meditating, it's important to keep your bedtime and routine consistent every night and wake up around the same time every morning.

Click here to read more about the importance of sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's unfortunate you're not functioning at your best today. You say you had a good quantity of sleep last night, but maybe the quality of your sleep is not as good as it could be? Having a good sleep routine — including a consistent bedtime and wake time — often is the key to getting the quality sleep night after night that your body needs for optimal health. Since you usually sleep this amount, if you often aren't feeling your best, you should consider talking to your doctor. Could you have an underlying condition? Are you feeling anxious or depressed? Have you taken medication that disrupted your sleep? Do you or could you have sleep apnea? Or do you naturally require a little bit more sleep?

Although sleep is crucial for optimal health, some research suggests that sleeping too much can also have negative consequences. Learn more about sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's unfortunate you're not functioning at your best today. You say you had a good quantity of sleep last night, but maybe the quality of your sleep is not as good as it could be? Having a good sleep routine — including a consistent bedtime and wake time — often is the key to getting the quality sleep night after night that your body needs for optimal health. Since you usually sleep longer, if you often aren't feeling your best, you should consider talking to your doctor. Could you have an underlying condition? Are you feeling anxious or depressed? Have you taken medication that disrupted your sleep? Do you or could you have sleep apnea? Or do you naturally require a little bit more sleep?

Although sleep is crucial for optimal health, some research suggests that sleeping too much can also have negative consequences. Learn more about sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's wonderful that you got a good night's sleep last night. Many people struggle to do so. Having a good sleep routine often is the key to getting the quality sleep night after night that your body needs for optimal health. Whether your sleep routine involves taking a warm bath, reading a book, or meditating, it's also important to keep bedtime consistent and wake up around the same time every morning.

Although sleep is crucial for optimal health, some research suggests that sleeping too much can have negative consequences. Learn more about sleep. If you're concerned about having trouble falling asleep, staying asleep, or sleeping too much, assess your risk for a sleep disorder.

It's unfortunate you're not functioning at your best today. You say you had a good quantity of sleep last night, but maybe the quality of your sleep is not as good as it could be? Having a good sleep routine — including a consistent bedtime and waking up at the same time — often is the key to getting the quality sleep night after night that your body needs for optimal health.

Since you usually get less sleep, please talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have insomnia, another sleep disorder, or conditions affecting your sleep.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

It's wonderful that you got a good night's sleep last night. Many people struggle to do so. Having a good sleep routine often is the key to getting the quality sleep night after night that your body needs for optimal health.

Since you usually get less sleep, talk to your doctor about your sleep patterns. Poor quality sleep can affect many areas of your life and health, and your doctor may be able to help you if you have insomnia or another sleep disorder or conditions affecting your sleep.

Learn more about the health consequences of sleep loss. If you're concerned about having trouble falling asleep or staying asleep, assess your risk for a sleep disorder.

SOURCES:

Centers for Disease Control and Prevention (CDC). Effect of short sleep duration on daily activities--United States, 2005-2008. MMWR Morb Mortal Wkly Rep 2011; 60:239.

Carskadon, MA, Dement, WC. Normal Human Sleep: An Overview. In: Principles and Practices of Sleep Medicine, Fifth, Kryger, MH, Roth, et al. (Eds), Elsevier Saunders, St. Louis, MO 2011. p.16.

Harvard University: "Sleep, Performance, and Public Safety."

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