Sleep Difficulties

What are sleep difficulties?

Most people will have periods in their life when they find it difficult to sleep. Sleep difficulties (also known as insomnia) include problems with getting to sleep, staying asleep or waking early.  A lack of quality sleep can lead to tiredness, poor concentration, slower reaction times and irritability. In turn, sleep difficulties can affect people’s work, relationships and quality of life.   

Sleep difficulties are often associated with anxiety and low mood. 

What is CBT for sleep difficulties?

As in all CBT, goals for therapy will be set together with the therapist after conversations to understand more about the problem and what the person coming for therapy wants to work on. Treatment will benefit from work in between sessions to try out the ideas being talked about. 

Cognitive behavioural therapy for sleep difficulties is a structured programme that helps to identify and change thoughts and behaviours that cause or worsen sleep problems, and create habits that promote sound sleep. Some of the aims of CBT for sleep difficulties include 
  • Understanding what might have caused the sleep problem and what might be accidentally keeping it going. This may involve keeping a detailed sleep diary for a couple of weeks
  • Recognising and challenging unhelpful thoughts about insomnia (e.g. worries about never being able to sleep)
  • Recognising unhelpful behaviours which might be accidentally maintaining the sleep problem (e.g. napping in the day or watching TV in bed)
  • Learning relaxation techniques to reduce the physical symptoms which can lead to sleeping problems
  • Thinking about routines just before bedtime and what to do about waking in the middle of the night
  • Making the sleeping environment as conducive to sleep as possible (e.g. thinking about the temperature and noise level in the bedroom)
  • Using CBT to help with anxiety or depression if these appear to be leading to the sleep problems

CBT has also been helpful in treating other sleep difficulties such as night-time panic attacks and bed-wetting.

Other resources  

You can download a pdf version of the information contained on this page.

For more about CBT for insomnia this article at is written by BABCP’s senior clinical advisor and is based on evidence about CBT for insomnia. 

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