Cognitive behavioral therapy for insomnia
The first step in treating insomnia with CBT-I is to identify the underlying causes of the insomnia. People with insomnia should evaluate or have their sleep patterns evaluated and take into account all possible factors that may be affecting the person's ability to sleep. This would involve keeping a sleep diary or journal for a couple weeks. The journal will help to identify patterns of thoughts or behaviors, stressors, etc. that could be contributing to the person's insomnia.
Cognitive behavioral therapy for insomnia
Sleep restriction is probably the most controversial step of CBT-I, since it initially involves the restriction of sleep. Insomniacs typically spend a long time in bed not sleeping, which CBT-I sees as creating a mental association between the bed and insomnia. The bed therefore becomes a site of nightly frustration where it is difficult to relax. Although it is counterintuitive, sleep restriction is a significant and effective component of CBT-I. It involves controlling time in bed (TIB) based upon the person's sleep efficiency in order to restore the homeostatic drive to sleep and thereby re-enforce the "bed-sleep connection". Sleep Efficiency (SE) is the measure of reported Total Sleep Time (TST), the actual amount of time the patient is usually able to sleep, compared with his or her TIB.