CBT for Insomnia & Cognitive Behavioural Sleep Therapy Delhi

Cognitive Behavioral Therapy for Insomnia (CBT-I)

Cognitive Behavioral Therapy for Insomnia (CBT-I) is a structured, evidence-based, and a non-drug treatment that helps people to identify and change their thoughts, beliefs, and behaviors that interfere with healthy sleep. It is considered as the first-line treatment for chronic insomnia and is more effective in long-term than sleeping pills.

CBT-I typically involves weekly sessions for 6–8 weeks, either in person, online, or through self-guided programs.

Causes

Insomnia can be triggered or maintained by several factors:

Stress and anxiety
Depression or other mental health disorders
Poor sleep habits (e.g., irregular sleep schedule, screen time before bed)
Medical conditions (e.g., chronic pain, asthma, GERD)
Substance use (caffeine, alcohol, nicotine)
Shift work or travel (disrupted circadian rhythm)
Overthinking about sleep (sleep performance anxiety)

Symptoms

Difficulty in falling asleep.
Waking up frequently during the night.
Waking up too early and not being able to return to sleep.
Daytime fatigue or sleepiness.
Irritability, low mood, or poor concentration.
Worrying about sleep every night.

Diagnosis

It is based on clinical history and sleep pattern assessment.
The tools which are used: Sleep Diary, Actigraphy, Polysomnography (if another sleep disorder is suspected).
Screening for underlying mental health or medical conditions.
Diagnosis confirmed if sleep problems last ≥3 nights/week for ≥3 months and cause daytime impairment.

Treatment

CBT-I is a multi-component therapy which includes:

Sleep Education: Understanding of normal sleep, and debunking myths.
Stimulus Control: Breaking negative associations (e.g., bed = stress).
Go to bed only when sleepy.
Use bed only for sleep and intimacy.
Wake at the same time daily.
Sleep Restriction: Limiting time in bed to actual sleep time to increase sleep efficiency.
Cognitive Restructuring: Identifying and challenging negative thoughts about sleep.
Relaxation Techniques: Breathing, meditation, progressive muscle relaxation.
Sleep Hygiene: Avoid caffeine, heavy meals, and screens before bed, etc.

Frequently Asked Questions (FAQs)

1. Is CBT-I better than sleeping pills?

Yes, CBT-I treats the root cause of insomnia, while pills only provide a short-term relief and can cause dependency or tolerance. CBT-I has long-lasting benefits.

2. How long does CBT-I take to work?

Most of the patients see improvement within 4–6 weeks, though some respond faster. The consistency and active participation are the main key.

3. Can I do CBT-I on my own?

Yes, There are self-guided CBT-I apps and online programs, but working with a trained sleep therapist is more effective for moderate to severe cases.

4. What if I have another condition along with insomnia?

CBT-I can be adapted for patients with anxiety, depression, chronic pain, or sleep apnea, and often helps improve both insomnia and the co-existing condition.