Insomnia can be frustrating and disruptive to your everyday life. Your body needs enough sleep to function properly, but no matter how hard you may try to fall asleep; insomnia prevents your body and mind from getting the rest it needs.
If you have tried to combat insomnia on your own without success, it may be time to consider a therapeutic solution. Cognitive behavioral therapy for insomnia (CBTI) and acceptance and commitment therapy (ACT) are both therapeutic insomnia treatments.
If you find yourself often wondering why you feel so tired, read on to learn more about these two treatments and determine which is best for your needs.
What Is Cognitive Behavioral Therapy for Insomnia (CBTI)?
Cognitive behavioral therapy for insomnia (CBTI) is a form of CBT that focuses on the connections between how you think, what you do, and how you sleep.
The term “cognitive” refers to your thought patterns, while “behavioral” references your actions. Discovering the link between these two processes and how they affect your sleep is key to reversing your insomnia symptoms.
CBTI treatment typically requires between six and eight weeks to treat insomnia. These sessions may include cognitive, behavioral, and psychoeducational interventions.
Cognitive interventions focus on pinpointing and altering any inaccurate thoughts you have about sleep. Behavioral interventions focus on implementing relaxation and stimulus control techniques to help you fall asleep more easily.
Finally, psychoeducational interventions teach you about the connections between your thoughts, behaviors, and sleep habits.
CBTI may be beneficial if you:
- Currently rely on sleeping pills to fall asleep
- Worry about sleep
- Have trouble falling back to sleep after waking up
- Feel fatigued and tired throughout the day
- Rely on naps to get you through the day
Often, individuals who experience insomnia develop harmful habits of thinking that inhibit their sleep. For example, they may feel anxious before bedtime or wonder, “Why am I so tired?” throughout the day, putting additional pressure on themselves to fall asleep on time.
Similarly, people with insomnia sometimes associate negative feelings with their bedrooms or beds due to their frustration about being unable to fall asleep. Stimulus control techniques limit the amount of time clients spend in bed when they are not sleeping, creating more positive associations with the bedroom.
Overall, research has shown that CBTI is an effective treatment for people experiencing insomnia.
Benefits of CBTI for Insomnia
CBTI can produce several benefits for individuals with insomnia:
● Improved mood
● Long-term results
● Reduced fatigue
● Reduced negative thoughts surrounding sleep
● Healthier sleep habits
What Is Acceptance and Commitment Therapy for Insomnia (ACT-I)?
Acceptance and commitment therapy for insomnia (ACT-I) is another therapeutic approach to insomnia.
This gentle, non-drug-based therapy focuses on helping individuals accept the psychological discomfort they may feel regarding their sleep habits. Practitioners believe that accepting the feelings of tiredness and fatigue that come with insomnia lowers the brain’s nocturnal arousal, leading to a restful, sleepy state.
Individuals with chronic insomnia typically experience a hyper-aroused state while trying to sleep rather than the lowered heart rate, slower breathing, and lower blood pressure that characterize pre-sleep physiology.
Often, this hyper-arousal results from the worry, anxiety, and other negative emotions individuals feel when thinking about their lack of sleepiness, resulting in a vicious cycle of insomnia. This cycle is a manifestation of a person’s unwillingness to accept that the negative emotions surrounding their lack of sleep are contributing to their inability to sleep.
ACT-I recognizes the unproductive nature of this cycle. Rather than using behavioral techniques to induce sleep, this therapy focuses on adopting an accepting attitude toward sleep difficulties through mindfulness, defusion, and normal valued sleep actions.
ACT-I focuses more on maintaining the natural processes involved in falling asleep than implementing new behavioral techniques.
Benefits of ACT for Insomnia
ACT-I can yield the following benefits for individuals with insomnia:
● Mindful acceptance of sleep processes
● Maintenance of natural sleep processes
● An objective, healthy view of negative emotions
CBTI vs. ACT for Insomnia
CBTI and ACT-I can both produce fruitful benefits for individuals with insomnia.
However, if you have never tried either of these treatments, you may be unsure which option is right for your sleep habits and lifestyle.
The primary difference between CBTI and ACT-I relates to changing behaviors. CBTI encourages several behavioral interventions that alter the way you act before and during bedtime. These interventions may include:
- Stimulus control: Using the bed only for sleep and sex and removing additional stimuli such as phones, food, computers, and TVs from the bedroom.
- Sleep restriction: Limiting one’s time lying in bed awake and leaving the room after spending more than 10 minutes awake.
- Progressive muscle relaxation (PMR): Tensing and relaxing muscle groups to encourage physiological sleep processes.
- Biofeedback: Monitoring physiological processes such as breathing, heart rate, and body temperature and attempting to control these processes before sleep.
Additionally, CBTI often involves psychoeducational interventions. CBTI practitioners may encourage clients to keep a sleep diary in which they record wake times, sleep times or thoughts and inaccurate beliefs regarding sleep, then attempt to challenge those thoughts with reality.
In contrast, ACT-I encourages clients not to change their sleep behaviors. Whereas CBT-I discourages clients from taking naps, using the bed for activities other than sleep, and leaving the bedroom during bouts of insomnia, ACT-I promotes these regular, valued sleep actions.
Final Consensus: Which Therapy Is Right for Me?
While ACT can be beneficial for individuals with mild insomnia, CBTI is generally a more effective treatment for fast, long-term insomnia relief. Many clients benefit more from a hands-on, proactive approach to their sleep issues, and changing their mindset about sleep is not enough to invoke sleepiness and correct their sleep patterns.