When it comes to my sleep-related services, that is the question I probably answer most often, and the answer is simple: by providing short-term, evidence-based, cognitive and behavioral interventions.
In other words, I provide a lot of education about the science of sleep and work collaboratively with my clients to apply the science of sleep and human behavior to develop interventions to gradually change their sleep-related behaviors.
That sounds way too simple.
Maybe so, but it’s what works!
It’s hard for me to scroll through social media without another celebrity touting the latest sleep aid, or without seeing commercials for the latest prescription or over-the-counter medications, apps, podcasts, and audios all intended to “help people sleep better.”
I love seeing sleep in the limelight, too. In our hurry-up-and-do-it-all world, we take it too much for granted. Even I used to sometimes say “I’ll sleep when I’m dead,” but I’ve since learned that that kind of mindset comes at a cost to my mental and physical health and performance.
Quick fixes usually don’t last
Many people claim that those quick fixes work. In some ways, that’s not altogether surprising to me; not only do some of the powerful prescription medications help your mind and body relax enough to push you into sleep, but even the belief that something can help may be just enough to help a person to relax and worry just enough less about falling asleep so that they’re able to actually do just that. Taking over-the-counter melatonin at bedtime is a great example of that and the placebo effect.
Unfortunately, those medications used to treat insomnia (difficulties falling asleep, staying asleep, or waking up too early) don’t really fix the problem. Moreover, they’re also not intended for long-term use. Some also cause unpleasant side effects that also affect daytime functioning.
Better, medication-free options
The good news, however, is that there are better options. The #1, most effective “gold standard” treatments for insomnia and many other sleep disorders are cognitive and behavioral. That is, treatments that help people to change some of their pre-existing beliefs and knowledge about sleep, as well as their sleep-related behaviors and daily routines. Both the American College of Physicians and the American Association for Sleep Medicine recommend CBTi – Cognitive Behavior Therapy for Insomnia – as the “front-line,” treatment-of-choice for insomnia.
CBTi
CBTi is typically a fairly short-term process, 4-8 sessions on average. After completing brief Intake Forms and providing us with any relevant medical records, the first session consists of a 1-hour intake, usually via telehealth, in which we discuss the context for current concerns and obtain a detailed sleep history. If preliminary information suggests that CBTi would be a good fit, we provide forms for tracking sleep to provide us with a solid baseline of current sleep habits (with no judgment!), followed by a 2nd appointment that focuses on education and collaborative development of an initial Intervention Plan that is not yet another ineffective “Sleep Hygiene” handout! Subsequent sessions provide ongoing monitoring and adjustments to the initial plan, address barriers to implementation, and teach clients how to continue to implement changes on their own. A final appointment is devoted to relapse prevention.
We treat more than Insomnia
Whether it’s insomnia or insufficient sleep, bedtime problems, difficulties adjusting one’s sleep schedule to fit daily life challenges like school start times, early or late night sports practices, shift work, or jet lag, or learning to tolerate CPAP devices for sleep apnea, explore explanations for persistent sleepiness or fatigue and more, we work collaboratively with clients, families, organizations, and related health providers to develop the individualized sleep-related strategies that can help clients of all ages sleep better and function better.
Check out some of the sleep-related handouts and websites on our Resources page, and reach out directly to learn more or to schedule an initial consultation.
