Cognitive behavioral therapy for insomnia (CBT-I) is the gold standard treatment for improving sleep – and is proven to be more effective than sleep medications for most people.

If you’re having trouble sleeping, you’re not alone. The National Sleep Foundation estimates that 70 million Americans suffer from chronic insomnia every year—and while many people can get by with an occasional sleepless night or two, others may find themselves struggling to fall or stay asleep most nights. If this sounds like you (or someone you know), it might be time to learn a few strategies for improving sleep or connect with a therapist who practices cognitive behavioral therapy for insomnia (CBT-I).

What is CBT-I?

Cognitive behavioral therapy for insomnia (CBT-I) is the gold standard treatment for improving sleep – and is proven to be more effective than sleep medications (sorry, not sorry, Ambien). It is a type of structured therapy that helps you change your sleep habits and improve your sleep naturally, often with long-lasting results. It’s based on the idea that your thoughts, behaviors, and habits affect how well you sleep. This means that if you have negative thoughts about sleep, or your mind is racing in bed, it will likely be harder to fall asleep or stay asleep. More than building good habits, CBT-I is about re-training our brains to sleep better and can yield long-lasting results.

How does CBT-I work?

In general, CBT-I helps people develop good sleeping habits so they can get back on track with their circadian rhythm (your internal clock) and develop effective sleep patterns. It includes several different components, including:

• Sleep scheduling — Setting up a regular schedule for when and where you go to bed each night will help regulate your body’s natural desire for rest; for example, going to bed at 10 p.m. consistently during the week, even a consistent time on weekends. Humans are creatures of habit and thrive on routine.
• Relaxation — Learning techniques like deep breathing exercises will calm down your mind so it doesn’t keep racing around at night. A relaxing bath, light reading, or mindfulness meditations are other strategies to help your mind and body relax and prepare for bed. You want your brain to feel tired, relaxed, and well, sleepy at nighttime.
• Cognitive restructuring — Changing how we think about things like being tired during our day or getting frustrated when we can’t fall asleep right away – can actually make it harder to fall asleep. Learning how to reign in overthinking and negative thoughts before beds are keys to getting a good night’s rest.

Below are ten practical tips that are part of a CBT-I approach for improving your sleep.

1. Set the right tone in your bedroom. 

Make your bedroom clean, tidy, and as dark as possible to create a calm environment conducive to sleep. The temperature in your bedroom should also be cool and comfortable. Remove any work materials (like laptops.) If you have pets that like to sleep with you at night, consider setting boundaries by giving them their own pet bed, or training them to sleep in another room. Pets often disturb your sleep by moving around too much or heating up the bed. A final note on distractions: no TV, computer, or smartphone in the bedroom – especially in the bed!

2. Adopt a nighttime routine.

• Adopt a nighttime routine to help your mind wind down – and stick with it.

You might be wondering if you really need a bedtime routine, but the answer is definitely yes. A regular routine before bed can help your mind relax and get ready for sleep. Try taking this hour to do things that help you wind down, such as reading, a self-care routine, a warm shower, or a bath. If it’s hard for you to fall asleep when your mind is racing with worries or thoughts about the day ahead, try journaling or relaxation techniques before bed instead of watching TV, playing video games, or scrolling through social media on your phone—those activities keep your brain active.

3. Avoid food two or three hours before bed.

• Late-night munching interferes with sleep.

Avoid eating two to three hours before bed. A heavy meal before bedtime can cause indigestion or bloating, which can keep you awake. If you are hungry and must eat close to bedtime, choose foods that are easy to digest and low in sugar. Avoid high-protein food like red meat, sweets, or processed foods close to bedtime because they take longer to digest or could lead to heartburn, abdominal pain, and gas. One client of mine who struggled with his sleep routinely ate hot dogs as a late-night snack. Not a great choice.  Instead, fiber-rich foods such as whole grains, vegetables, and fruits are also good choices at night because they are good sources of nutrients but low in calories — so they won’t make you gain weight if eaten at night.

4. Dim the lights after dinner.

• Simulate the sun setting in your own home.

This is a simple way to signal to your body that it’s time for bed. Try dimming the lights in your house 30-60 minutes before bedtime and limit the amount of time you spend on electronics during this time. Not only will this help you wind down and relax before hitting the hay, but it may also help reduce insomnia symptoms like difficulty falling asleep and frequent waking during the night.

5. Exercise during the day.

Daytime exercise can positively impact your sleep. For some people, this means exercising in the morning or right after work. If you had a good workout during the day, there’s a greater chance your body will be out of energy and ready to shut down at night. A tired body creates a tired mind.

6. Don’t exercise within three hours of bedtime.

It’s best to avoid high-intensity workouts out within three hours of bedtime. Exercise has countless benefits but also has stimulant effects on the body, mind, and circadian rhythm. If you exercise too close to bedtime, your body might feel pumped up, or your mind might feel “wired.” It can also interfere with the quality of your sleep by increasing alertness and stimulation, making it difficult to relax.

The type and intensity of exercise matters: low-intensity exercises like walking, stretching, or certain types of yoga (yoga nidra, restorative yoga) can actually better at improving sleep than high-intensity workouts (like running).

7. Limit electronics before bedtime.

• Limit “screen time” (TV, computers, video games, smartphones, and tablets) and shut them off 30 to 60 minutes or more before you go to bed. Keep devices out of the bedroom if you can’t put them away or try having them charging on the other side of the room. Television and apps can stimulate your mind when it should be winding down. Upsetting news, an annoying post, or even thought-provoking content can keep your mind spinning fast rather than slowing down. The blue light from these devices is particularly disruptive because it suppresses the body’s production of melatonin—the hormone that helps regulate sleep cycles. 

8. Keep your bedroom cool at night.

One of the easiest ways to help you get a better night’s sleep is by keeping your bedroom at a cool temperature. Your body needs to be able to cool down in order to fall asleep, so it is important that your room stays below 70 degrees Fahrenheit at night. A nice fan to simulate an ocean breeze can help, too.

9. Don’t lie in bed awake for more than 30 minutes.

If you wake up in the middle of the night and can’t fall back to sleep, get up and do something else. But don’t stay in bed awake for long periods of time; it will make your brain more active, which is not conducive to sleepiness. If you aren’t asleep after 30 minutes, get up and do something else—read a book, walk around the house, go to the bathroom.

10. Avoid substances like caffeine, nicotine, alcohol, and cannabis before bedtime.

It’s important to avoid stimulants like caffeine and nicotine (including vaping) before bedtime. Caffeine and nicotine are both stimulants that may keep you awake. Caffeinated tea, soft drinks, and chocolate can cause problems, too.

The same goes for alcohol: although a glass of wine or beer might help you relax after a long day at work or school, it can disrupt your sleep later in the night by increasing your heart rate and blood pressure. Your body also has to work hard to metabolize the alcohol while you’re sleeping – resulting in reduced sleep quality and midnight trips to the bathroom.

Cannabis is also problematic. While it can sometimes help people fall asleep, it degrades the quality of sleep and can leave your mind feeling groggy or fuzzy in the morning. Not to mention you could have a bad trip.

 

Better sleep is key to health and high productivity. 

• If you’re not getting enough sleep, chances are you’re not the only one who notices. Your sleep quality affects your mood and focus the next day, which can lead to feeling more tired and having trouble concentrating on work or home tasks. A better night’s rest will help you be more productive at work, with your family, or with anything else that requires a clear head.

Insomnia can be overcome by learning strategies CBT-I or participating in a CBT-I treatment program.

While you may think that insomnia is just a part of life, the fact is that it can be overcome. The key lies in learning strategies through Cognitive Behavioral Therapy for Insomnia (CBT-I), which has been found to be a highly effective way to correct sleep habits and eliminate problems with sleeping. This therapy teaches patients how to develop positive habits related to their sleep patterns and lifestyle choices.

CBT-I isn’t a one-size-fits-all approach; a trained therapist will evaluate your individual needs and help formulate an action plan for overcoming them. You will learn about things like setting up an appropriate environment for sleep and relaxation, managing stressors in your life (including those caused by work or school), developing healthy eating habits, and creating consistency with bedtimes so that they become automatic behaviors.

If you have tried other methods of improving your sleep without success, consider CBT-I. You may end up with amazing, long-lasting results.

Bottom Line

The strategies above are just a few of the many available for improving sleep. They are not a substitute for professional help, but they can be a good way to get started on the path to better sleep. If you find that these tips aren’t working or if your insomnia is interfering with your daily life, it’s time to talk with your primary care provider or a psychologist about what options might be right for you.