National Sleep Foundation

Chapter 2: Insomnia

CBT – Cognitive Therapy

Cognitive Therapy

Cognitive therapy seeks to change a person’s dysfunctional beliefs and attitudes about sleep.1
Cognitive
therapy is often needed before other behavioral treatments can be implemented. For example, if an individual has the erroneous belief that his insomnia is caused solely by a biochemical imbalance, he is unlikely to accept a course in relaxation therapy.

When practicing cognitive therapy, therapists endeavor to guide patients to draw their own conclusions, since durable change is best achieved when patients discover the facts themselves. Table 2.3 provides examples of cognitive treatment targets for this form of CBT.

Table 2.3: Examples of treatment targets for cognitive therapy.2

Treatment Target

Example of Dysfunctional Belief or Attitude

Unrealistic Sleep Expectation Dysfunctional belief: “I must get 8 hours of sleep every night.”
Misconceptions about the causes of insomnia Dysfunctional belief: “My insomnia is entirely due to a chemical imbalance.”
Amplifications of insomnia’s consequences Dysfunctional belief: “One can accomplish absolutely nothing after having a poor night’s sleep.”
Anxiety resulting from counter-productive attempts to control the sleep process Dysfunctional belief: “I get overwhelmed by my thoughts at night and often feel I have no control over my racing mind.”

 

References

  1. Morin CM, Hauri PJ, Espie CA, Spielman AJ, Buysse DJ, Bootzin RR. Nonpharmacologic treatment of chronic insomnia. Sleep. 1999;22:1134-1156.
  2. Morin CM, Hauri PJ, Espie CA, Spielman AJ, Buysse DJ, Bootzin RR. Nonpharmacologic treatment of chronic insomnia. Sleep. 1999;22:1134-1156.