Insomnia Therapy

Sleep difficulties are very common. About 33% to 50% of adults report frequent difficulty falling asleep or staying asleep. About 7% to 18% of adults experience sleeplessness often enough that they are diagnosed with insomnia disorder. (9)

The first step of this program is a free consultation and then an assessment to clarify your sleep situation.

Citation

(9) https://jcsm.aasm.org/doi/10.5664/jcsm.26929

It is great you’re already working on these strategies otherwise known as “sleep hygiene” However, research shows that sleep hygiene on its own is not enough. (10)

These strategies won’t hurt anything but typically they aren’t enough to reset sleep after insomnia has started. CBT-I takes this several steps further to help you reset your sleep.

Citation

(10)https://www.med.upenn.edu/cbti/assets/user-content/documents/btsd--sleephygiene-bsmtxprotocols.pdf

This is an excellent question. Often the initial trigger for insomnia is different from what keeps insomnia going.

Initial triggers for insomnia vary widely but some common examples are: medical problems, work problems, family conflict, grief, change in schedule, new infant etc. For some people, the situation resolves on its own but for others the insomnia becomes chronic.

The reasons why insomnia sticks around are not the same as the initial trigger. CBT-I targets the factors that make insomnia chronic. (11)

(11) https://europepmc.org/article/med/26978509

CBT-I helps with resetting your brain and body to be able to sleep consistently. However, if something outside your own brain/body is the only reason for the sleep issues, it would be more effective to address the problem directly first (For example, sleeping in separate beds, white noise machines, or other creative solutions).

In other words, your bed partner is the only reason you wake up and you fall asleep quickly after the noise or movement and have no issues with insomnia when sleeping alone, CBT-I wouldn't change much.

However, often the noise is only part of the problem and CBT-I helps with the rest. Stress and anxiety predispose, or make someone more likely to be awoken by their bed partner. (12)

In the first session, we will do a thorough assessment. I'm ethically bound to only provide services with a "reasonable promise of success" so I would only recommend continuing if CBT-I is likely to benefit in your specific circumstance.

This is from the CBT-I support page of the Center for Deployment Psych which I think adds some clarity to the situation as well:

"For some patients, difficulty sleeping can be attributed to a specific source, such as a noisy bed partner or uncomfortable mattress. In these cases, targeting the problem directly can help. However, patients with sleep problems generally have multiple contributing factors, particularly if the insomnia has become chronic. That means it is unlikely that simply targeting sleep hygiene will be helpful, and indeed, research demonstrates that for patients who have Insomnia Disorder, even if they have poor sleep hygiene, sleep hygiene interventions alone are ineffective.

Unless your patient has an easily identifiable single source of sleep problems or sleep problems are acute, CBT-I is recommended.” (13)

Citations:

(12) https://pubmed.ncbi.nlm.nih.gov/32421592/

(13) https://deploymentpsych.org/content/faqs-cognitive-behavioral-therapy-insomnia-cbt-i

All these factors can influence sleep, but sleeping well can actually help reduce stress, anxiety, improve mood and numerous other positive impacts.
In other words stress and mood can make it hard to sleep, and sleeping poorly can worsen stress and mood.

Treating the sleep symptoms (by joining this group) helps reduce anxiety, depression, stress and trauma symptoms.
Of course you can also work on the anxiety, work stress, PTSD and depression as well but improving sleep can help you along the way.