Cognitive Behavioral Therapy for Insomnia

Sleep disturbances, common among those in recovery, are not only a nuisance, they can also derail new-found sobriety. When you’re sleep deprived, you don’t function at your optimum level. Even without being in recovery, sleep deprivation makes a person more susceptible to developing infections, high blood pressure, diabetes, cardiovascular disease – and to making on-the-job mistakes, driving errors and having other problems with learning and memory. Multiply those problems with those that you experience in recovery – depression, anxiety, guilt, shame, feelings of inadequacy and more – and you have a nearly sure-fire recipe for disaster.

It doesn’t have to be so.

Sure, there are medications that are available to aid in sleep, but these shouldn’t be taken by those in recovery. They are only meant for a few days, and they can easily become habit-forming. Not a good thing for a person in recovery. You never want to add to your addiction profile by taking yet another drug when you just got clean and sober through treatment. Besides, sleeping pills lose their effectiveness over time, and also contribute to the following:

• Potentially severe interactions with alcohol and other medications

• Rebound insomnia or constant grogginess that leads to more insomnia

• Short-term amnesia, dizziness, nausea, weakness, confusion and high blood pressure

• Mask underlying causes, such as depression, heart trouble, or other diseases, and cause delay in seeking treatment

• Bizarre behavior that goes beyond traditional sleepwalking

Cognitive Behavioral Therapy (CBT) Can Help

One treatment therapy you may be familiar with from your days in treatment is cognitive behavioral therapy, or CBT. In fact, CBT has emerged as a very effective treatment for those suffering from insomnia, or chronic sleep disturbances. It is an excellent and safe alternative to sleeping pills.

This short-term treatment also can assist in ridding you of depression, panic attacks, anxiety and other problems associated with your former drug or alcohol use. In a review of insomnia treatments conducted by the American Academy of Sleep Medicine in 2006, CBT was found to provide sleep benefits that are sustainable over a long period of time.

How CBT Works

CBT works by helping you to change thoughts and actions. With respect to an inability to sleep, CBT targets those thoughts and actions that interfere with sleep. The approach is based on the fact that what you think and how you act affect the way you feel. Treatment usually requires 4 to 8 30-minute sessions with a trained CBT sleep therapist. Through CBT techniques, you learn to:

• Recognize and change false beliefs that may be interfering with your good night’s sleep

• Deal with misperceptions you may have about how long you actually sleep

• Reprogram your brain’s sleep-wake cycle

• Target specific behaviors that negatively impact sleep, including lack of exercise and drinking caffeinated beverages before going to sleep

Different CBT Elements for Dealing With Insomnia

CBT uses a multi-faceted approach to dealing with insomnia, just as it does in treating other conditions. Some or all of the following may be effective in your particular case. But CBT does require practice in order to be most effective.

• Relaxation training – includes muscle relaxation, meditation and hypnosis

• Biofeedback – measures muscle tension and brain wave frequency, with the goal of helping you to control them

• Sleep restriction – reducing the amount of time you spend in bed not sleeping

• Sleep hygiene – eliminating negatively impactful activities such as drinking caffeine, smoking, not exercising regularly

• Stimulus control – helps you associate the bedroom with only two activities: sleep and sex

• Remaining passively awake – a technique that helps you avoid anxiety about going to sleep, forgetting about it, so that you eventually fall asleep

• Cognitive control and psychotherapy – A technique to eliminate or control worrisome thoughts or mistaken beliefs that keep you awake

How to Find a CBT Insomnia Therapist

Contact your aftercare counselor or therapist for a recommendation on CBT for your insomnia. Another suggestion is to check out the American Academy of Sleep Medicine website at http://www.aasmnet.org/. Click on the “Patients and Public” tab at the top of the page, and click the link to “Find a Sleep Center.” You will be able to find a sleep center by clicking on the map.

Another source is the National Sleep Foundation at http://www.sleepfoundation.org/ and click on “Find a Sleep Professional” tab. There’s also a good list of Q&A on “Choosing a CBT for Insomnia Specialist” in this link http://www.sleepfoundation.org/article/ask-the-expert/choosing-cbt-insomnia-specialist.

Also listen to some CBT tapes or read books on CBT and insomnia available in your local library. These may be a more practical help until you are able to find a CBT therapist in your area.

The important thing is not to give up. You deserve a restful night’s sleep and, in fact, it’s the only way you’ll be able to continue with your goals for your recovery. Don’t sell yourself short getting by on less sleep than you really need. With practice and determination, you can lick your sleep disturbance problem – just as you kicked drugs and alcohol. After all, you’ve got all the tools at your disposal. Now, it’s just up to you to use them.

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