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Curing Chronic Insomnia With Behavioral Therapy

If you have trouble getting or staying asleep for at least three nights over the course of at least three months, you likely have chronic insomnia. The disorder, which the American Academy of Sleep Medicine estimates occurs in about 10 percent of Americans, isn’t something to take lightly.

“We know lack of sleep can contribute to a myriad of health issues and affects nearly every single organ system in the body,” says Michelle Drerup, a sleep psychologist and behavioral sleep medicine specialist at the Cleveland Clinic Sleep Disorders Center.

When to go to your doctor

Despite the potentially distressing effects of insomnia — including lack of focus, exhaustion and anxiety — you might not feel comfortable or have time to consult your doctor about treatment options. But doing so can open a window to various options, including a type of cognitive behavioral therapy for insomnia (CBTI) — the first line of treatment for chronic insomnia.

“CBTI is the most researched most effective treatment for insomnia,” says Drerup, adding that medication and alternative treatments, such as supplements, may work as second-line options.

You might seek out in-person or virtual CBTI sessions, either on an individual basis or in a group. The approach focuses on identifying factors that can lead to sleep trouble, re-associating the bed with sleep, and teaching strategies for reducing “the mental and physiological arousal that develops at night when they start to have sleep problems,” Drerup says. Such strategies may include meditation or yoga.

Finding the triggers of insomnia

Each person maintains a sleep log, which their sleep specialist uses to help him or her identify insomnia triggers.

But even when a trigger is gone, insomnia may continue, especially if a person has developed mechanisms to cope with lack of sleep that then end up still exacerbating sleep. “It really becomes a vicious cycle,” Drerup says.

“A lot of times people will say, ‘The only thing I’m stressing about now that I’ve had sleep for so long is sleeping,’” she says. “A lot of what CBTI does is help them figure out how to address some of those thoughts and worries about sleep as well, so that they’re more constructive.”

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