This may involve keeping a sleep diary/journal for a couple of weeks, which can help identify patterns of thoughts or behaviors, stressors, etc.
[1] After identifying the possible underlying causes and the factors contributing to insomnia, the person can begin taking steps towards getting better sleep.
Importantly, they should limit stimulating activity such as watching television, using a computer or being around bright lights.
[8]) Daytime sleepiness is a side-effect during the first week or two of treatment, so those who operate heavy machinery or otherwise cannot safely be sleep deprived should not undergo this process.
Research has showed that sleep restriction therapy does create side effects such as "fatigue/exhaustion", "extreme sleepiness", "reduced motivation/energy", "headache/migraine", irritability, and changes in appetite.
But the frequency and ratings of how much these side effects interfered were associated with improvement in sleep quality over the course of the treatment.
[9] In another study, results of questionnaires measuring impairment through the psychomotor vigilance task (PVT) and the Epworth sleepiness scale (ESS) were stabilized at a normal level at 3-months follow-up.
Cognitive therapists will directly question the logical basis of these dysfunctional beliefs in order to point out their flaws.
If instead a person actively tries to generate energy by taking a walk, talking to a friend and getting plenty of sunlight, he or she may find that the original belief was self-fulfilling and not actually true.
Therapists will work to control worry and rumination with the use of a thought record, a log where a person writes down concerns.
Paradoxical Intention is a treatment method which involves telling the patient to do the exact opposite of what they have been doing in bed: They should stay awake and avoid falling asleep.
Common symptoms of PTSD include nightmares, flashbacks and hyperarousal (fight-or-flight), all of which can induce insomnia and fatigue in various ways.
The participants in studies displayed reduction of PTSD symptoms which lead to insomnia, such as nightmares and general fear of sleep after undergoing CBT-I.
suggest that CBT-I in combination with imagery rehearsal therapy further lessens sleep-related PTSD symptoms.
CBT-I has been shown to be an effective treatment in these cases[32] as it may improve mood, overall quality of life and lessen fatigue.
[33] In studies examining sufferers of chronic pain induced insomnia via hyperarousal, CBT-I has been shown to improve sleep continuity and reduce impairment in daily functioning.
[36] A 2014 study suggests that acceptance and commitment therapy might even be effective in patients not responding to CBT-I.
A 2023 systematic review[39] demonstrated that just stimulus control and sleep restriction are effective treatment options for insomnia in older adults.