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  • Writer's pictureAli Brown

Cognitive Behavioral Therapy for Insomnia (CBTi) - An approach to addressing those sleepless nights

In this month's blog, Dr Jenna Renfroe is introducing us to a research backed approach to addressing insomnia, called Cognitive Behavioral Therapy for Insomnia or CBTi. As you will hopefully have learned from our earlier posts on brain health (take a look at January and March's posts for some of the most important health habits to improve brain health), an adequate amount of quality sleep is vital for promoting and protecting long term brain health and short term brain function. We at Tailored Brain Health know that asking for help, especially from a mental health professional, can be intimidating. So this month we want to give you an idea of what is involved in one of the approaches to address a common mental health complaint, insomnia. Whether your sleep issues are recently developed or long standing, we hope that this information will give you the comfort and confidence to make some healthy changes and to reach out for support if you need it. We are here to help! So keep reading for Dr. Renfroe's summary of what this research backed approach entails and take some of the mystery out of mental health care!


CBT-I (Cognitive Behavioral Therapy for Insomnia) is a highly effective treatment for insomnia that does not require medication. Insomnia can be a frustrating and debilitating condition that affects a person's ability to function during the day. It can lead to fatigue, irritability, difficulty concentrating, and a decreased quality of life. Fortunately, CBT-I has been proven to be a safe and effective treatment for insomnia, and is comprised solely of behavioral interventions.

The first component of CBT-I is sleep hygiene education. Sleep hygiene refers to the behaviors and habits that help promote good sleep. It involves things like establishing a regular sleep schedule, avoiding stimulating activities before bedtime, and creating a relaxing sleep environment. Other key components to sleep hygiene are avoidance of caffeine and alcohol, especially in later hours of the day where these substances can impact the quality and duration of the sleep cycle. By learning about good sleep hygiene, people can make changes to their sleep habits that can lead to better sleep.

The second component of CBT-I is called stimulus control therapy. Stimulus control therapy is based on the idea that people can become conditioned to associate the bed with activities other than sleep, such as watching TV or working. This can interfere with their ability to fall asleep when they get into bed. Stimulus control therapy involves re-associating the bed with sleep and eliminating activities that interfere with sleep. For example, people are encouraged to use the bed only for sleep and sex and to avoid other activities that can interfere with sleep, like playing on their cell phone, working, or watching TV in bed.

The third component of CBT-I is sleep restriction therapy. This involves limiting the amount of time spent in bed to match the amount of time spent sleeping. This can be difficult at first, as people may feel tired during the day. However, by gradually decreasing the amount of time spent in bed, people can improve their sleep efficiency and reduce the amount of time spent awake in bed.

The fourth component of CBT-I is relaxation training. This involves learning various techniques, such as progressive muscle relaxation or deep breathing exercises, to help reduce stress and promote relaxation. By learning how to relax, people can reduce their anxiety and improve their sleep quality.

The fifth component of CBT-I is cognitive restructuring. This involves identifying and challenging negative thoughts and beliefs about sleep that may be contributing to insomnia. For example, people may believe that they need eight hours of sleep every night, and that if they don't get it, they won't be able to function during the day. Cognitive restructuring helps people to identify these negative thoughts and beliefs and replace them with more positive and realistic ones.

Overall, CBT-I is a highly effective and evidence-based treatment for insomnia. It is a structured program that involves several different components, each of which is designed to help people improve their sleep. If you are struggling with insomnia, consider talking to a healthcare provider about whether CBT-I might be right for you. By making changes to your sleep habits and learning new techniques for relaxation and stress reduction, you can improve your sleep and quality of life.

CBT-I is available through our licensed psychologist at Tailored Brain Health. If you are interested in this behavioral approach for sleep disturbances, please call us at 336-542-1800 or email


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