Behavioral Therapy

Specific behavioral and cognitive techniques can successfully be used to treat sleep problems like insomnia, habituation to CPAP treatment, nightmare management and problematic sleep-related eating behaviors. The most developed and widely used behavioral therapy approach is a technique used to treat insomnia, known as cognitive behavior therapy (CBT-I) for insomnia.

Change in behaviors related to sleep and attitudes and thinking about sleep can help to resolve insomnia. Behavioral therapy can be used instead of, or in combination with, short-term use of medications. Behavioral therapy techniques have been found to be as effective as medications in treatment of insomnia. Behavioral therapy has been found to produce improvements that are longer lasting than those of medications. Insomniacs can learn skills that can be used repeatedly to manage their own insomnia at home and allow them to develop a greater sense of control over their sleep problem.

CBT-I Techniques Include:

  • Progressive relaxation and other relaxation techniques
  • Stimulus control
  • Sleep hygiene instruction and education about sleep
  • Adjustment of sleep/wake schedule
  • Sleep restriction
  • Systematic desensitization
  • Assessment and analysis of eating behavior and how it may interfere with sleep
  • Development of plan for systematic change in eating behavior that may interfere with sleep

Other Behavioral Therapy Treatments for Sleep Problems Include:

Cognitive Techniques

  • Cognitive restructuring
  • Covert assertions and imagery
  • Applications of social cognitive theory, particularly with respect to approach to CPAP use and adaptation, for those who have sleep apnea
  • Imagery rehearsal therapy for nightmare reduction
  • Exploration of thoughts that may contribute to behavior that interferes with sleep

Bright Light Therapy

  • Recommendations regarding use of natural outdoor light to adjust sleep-wake schedule
  • Exposure to light box therapy

Psychotherapy

  • Identification of and counseling for psychosocial factors that are implicated in sleep disturbance
  • Counseling for weight management