Insomnia and sleep disorders
In February, 2020, I completed my certification in Cognitive Behavioral Therapy for Insomnia: Evidence-based Insomnia Interventions for Trauma, Anxiety, Depression, and Chronic Pain. This is commonly known as CBTi. I have long been interested in treating insomnia and sleep disorders. My training allows me to provide brief, evidence-based therapy to help you learn to sleep better, and to treat the root causes of your sleep issues. You may have been relying upon sleep medications and, if so, I will want to coordinate with your doctor to help you wean yourself off of medications and learn to trust your body’s ability to sleep. It is normal to experience rebound insomnia if you have been relying upon medications for years, and I am compassionate and understanding about the anxiety you might have about getting off of pills. This needs to be a careful and collaborative process.
CBTi begins with a thorough assessment to rule out medical issues that may be disrupting your sleep, such as sleep apnea, periodic leg movements (restless leg syndrome), narcolepsy, in addition to primary insomnia. I can also assess for parasomnias such as sleepwalking, REM behavior disorders, and sleep talking or eating. If I suspect there are medical issues, we may need to refer you to a sleep clinic so that your sleep can be measured and observed overnight.
Assuming we do end up treating insomnia, keeping a Sleep Diary will be a major component of this work as will be modifying your bedtime and wake time and other behaviors. We will also be exploring your beliefs about sleep (some of which may be keeping you up at night!). You will learn about sleep hygiene and we will monitor your progress with specific changes. We will also work together on mindfulness and relaxation strategies and plans for what to do when you do find yourself awake at night.
If it turns you that you have sleep apnea and this has been disrupting your sleep, I can help you with your approach to using a CPAP or APAP device, assisting you in getting more comfortable using it. Some people experience discomfort with mask fit and others feel claustrophobic from the mask itself or air pressure. I can work with you to help you relax and get regular use of this device which can be quite transformative for your sleep quality when used consistently over time.
I also have been trained in some of the challenges for people with sleep disturbances and PTSD, as well as chronic pain and TBI (Traumatic Brain Injury). If nightmares are part of your sleep concerns, I have also been trained in Imagery Rehearsal Therapy which can help you take back your night, so to speak. If these are things you need help with, don’t hesitate to contact me. Sleep is too precious to go without.