![]() ![]() Stimulus Control: This method helps remove factors that condition your mind to resist sleep. It also includes tips that help you sleep better, such as ways to wind down an hour or two before bedtime. Sleep Hygiene: This involves changing basic lifestyle habits that influence sleep, such as smoking or drinking too much caffeine late in the day, drinking too much alcohol, not getting regular exercise, engaging in non-sleep activities in the bed (reading, watching TV, using electronic devices, etc). Harte may recommend some of these CBT-I techniques: You will be asked to keep a sleep diary for 1-2 weeks that will be used to tailor sleep interventions to the specific nature of your sleep problem.ĭepending on your needs, Dr. CBT-I also helps you to alter and eliminate many behaviors and lifestyle factors that negatively affect your sleep.ĬBT-I starts with a comprehensive assessment of your sleep history, as well as assessing your medical history, psychological history, social and environmental factors that may affect sleep, and your lifestyle. This type of therapy can help you better manage negative thoughts and worries that keep you awake. Negative sleep thoughts can also affect daytime functioning as with the thought, "today is going to be very difficult because I didn't sleep well last night." This becomes a self-fulfilling prophesy and the day ends up being very difficult due to negative expectations and irritable mood.CBT-I teaches you to recognize and change beliefs that affect your ability to sleep. Little wonder that upon awakening it seems that no sleep has occurred as this light sleep is misinterpreted as wakefulness. Stress tends to prevent cycling into deep sleep so the person may spend long periods of time in poor quality light sleep in which there may be an awareness of ongoing non-productive thinking. For example, thoughts such as "tomorrow will be terrible if I don't get enough sleep tonight" are likely to make it very hard to relax and then fall asleep. This makes it difficult to sleep and causes the experience of trying to sleep, feel miserable. Negative thinking, especially the fear of the effects of not sleeping, increases arousal. ![]() People with insomnia tend to overestimate how long they take to fall asleep and underestimate how long they actually sleep. Some additional facts are also important to know. In a previous post I discussed how insomnia is actually a problem of over-arousal and that insomnia mainly affects daytime emotion and quality of life ratings and does not generally pose a health risk to the person suffering from it. Second, it is important to have accurate information about sleep and insomnia in order to be able to recognize and challenge negative, distorted thoughts regarding it. In a less dramatic way, beliefs about sleep and insomnia can affect the quality and quantity of one's sleep. This has been documented by anthropologists and is a very real phenomenon. ![]() An example of a nocebo is the rapid death of individuals who have been cursed by a sorcerer in certain pre-modern societies. This has been referred to as the nocebo effect. ![]() Likewise, negative beliefs about substances or behaviors can lead to unhealthy outcomes. This effect is so strong that specific placebo control methods must be used in pharmacological research that tests new medications. A placebo is a pharmacologically inert chemical that has a positive health effect because of the belief of the person taking it. Common examples of this are the placebo and nocebo effects. Most likely anyone reading this blog will be familiar with the impact of belief on health. The first step in using these techniques to treat insomnia is to understand the power of cognitive processes in our emotional states and general health. ![]()
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