Insomnia Treatment: When & How to Seek Therapy

If you’re struggling with insomnia, you’re not alone: 30%-35% of American adults experience symptoms of insomnia sometimes, while the condition is chronic for 10% of adults. If you’re dealing with insomnia, you might feel unrested in the morning, and many people find that insomnia gets worse in response to life stresses or anxiety.

Because just about everyone has troubling falling asleep from time to time, it can be hard to know whether you should seek professional treatment. If you think that therapy for insomnia might be helpful for you, read on for when to seek professional support, how to find the right insomnia therapist for you.

When should I seek therapy for insomnia?

You might seek therapy for insomnia if you find you are:

Lying awake at night having trouble falling asleep
Waking up often during the night
Worrying about sleep during the day
Feeling so tired that you have difficulty with daytime activities

You don’t need to be experiencing severe insomnia to seek therapy; even a session or two can be helpful for people with mild symptoms of insomnia. A therapist specializing in insomnia treatment can help you at any acuteness level, including:

Acute or short-term insomnia: Sleep difficulties that last less than a month, which frequently arise in reaction to life stressors.
Chronic insomnia: Sleep difficulties that occur three nights a week for at least one month, cumulatively lasting for more than six months. Typically doesn’t have a causal precipitating event, and commonly has negative impacts on psychical health, mental health, and daily life.

A lack of sleep can compromise your immune system as well as lead to higher risk of mental health conditions such as depression and anxiety, so early assessment and treatment is important.

What can I do to improve sleep issues on my own?

There are also things you can do on your own to try and improve your insomnia symptoms. A few options include:

Avoiding using your phone, your computer, or other electronics in the bedroom. The bright light from screens can interrupt your body’s natural inclination to sleep, and stressors like email or news feeds might also make it hard to quiet your mind.
Using blackout curtains, eye masks, or ear plugs to make your bedroom more conducive to sleep.
Avoiding consuming caffeine or alcohol later in the day.
Learning simple mindfulness and breathing exercises to calm your mind when you begin to experience worry about sleeping.
Trying out an app like Calm to distract your mind and lull you to sleep.

The more intense or frequent your insomnia symptoms are, the more likely it is that working with a therapist could be necessary for you to see improvement.

What kind of therapy is helpful for insomnia?

While many forms of psychotherapy may the reduce anxiety and worry that can contribute to insomnia, cognitive-behavioral therapy for insomnia (CBT-I) has been found to be an especially effective treatment for those who wish to improve insomnia symptoms without relying on medication.

The American College of Physicians states that CBT-I is the most highly recommended therapy for adults dealing with insomnia, noting that it has been found to lead to sustained positive results in a number of studies with various populations.

What happens in CBT for insomnia?

CBT-I combines a screening and analysis process with specific techniques for reducing symptoms, with the goal of creating a therapy experience tailored to your particular experience of insomnia.

In CBT-I, your therapist will guide you though three major steps:

Screening for medical issues and assessing sleep by a qualified provider.
Targeting issues and methods to treat the insomnia particular to your case.
Gradually employing techniques to correct sleep problems.

After ruling out medical causes for your symptoms, your therapist will guide you through an analysis of your personal sleep hygiene (when you go to bed, how you organize your bedroom, what your bedtime routine is, etc.) and then work with you to build a customized treatment plan. In many cases, you’ll also document your sleep habits using a log or an app like Sleep Cycle in order to pinpoint potential areas for change.

Additionally, you’ll spend time in sessions working through standard cognitive-behavioral therapy exercises with your therapist, which can include correcting cognitive distortions around sleep and learning techniques to manage stress and anxiety.

Your therapist may also give you worksheets or other assignments to complete between sessions. This aspect of treatment helps you understand the thoughts and worries that you may have around sleep, while working toward changing these thoughts to create a more peaceful approach to sleep.

For some, changes in sleep hygiene practices combined with cognitive-behavioral techniques will be enough to improve symptoms. In other cases, your therapist may also recommend a customized set of change to your sleep schedule, such as waking up strictly at a certain time or avoiding naps during the day. In every case, your therapist will work collaboratively with you make sure that any proposed changes are manageable and that you have tools to handle any anxiety they may cause.

How long can I expect to attend CBT-I sessions?

The recommended length of treatment of treatment for CBT-I is eight sessions. However, some studies have found that treatment for as little as two sessions can also be effective, especially when combined with follow-ups over the phone.

Do group therapy sessions work for insomnia?

Though CBT-I was originally developed as an individual therapy, a recent study found that CBT conducted in a group setting can also be an effective treatment for insomnia. Though this treatment option is less common, you can ask potential therapists whether they currently offer or are planning any treatment groups for CBT-I.

What should I look for in a therapist for insomnia?

Seek out a therapist who specializes in cognitive-behavioral therapy for insomnia (CBT-I).

CBT-I has been found to be an especially effective treatment for those who wish to improve insomnia symptoms without relying on medication.

According to The American College of Physicians, CBT-I improves sleep and daytime functioning by 70-80%, improves mood, and reduces co-morbid concerns like depression. It is a powerful approach that leads to the reduction of anxiety about sleep, and reduces the existing symptoms of insomnia.

In addition, as with any therapist, make sure your insomnia therapist is in-network with your health insurance or has session fees within a budget you can afford, and that you feel a strong personal fit, or therapeutic alliance.

What questions should I ask when choosing a therapist for insomnia?

In addition to seeking out a therapist who has experience treating insomnia and who has been trained in using CBT-I, you might consider asking potential therapists for insomnia the following questions:

What kinds of insomnia symptoms do you treat?
Do you work with other practitioners to rule out medical causes of insomnia?
What tools and assessments do you use in treating insomnia?
Do you assign homework between sessions?
How do you creat individually tailored treatment plans for insomnia?

If your insomnia is related to a specific form of stress or anxiety (workplace stress, phobias, PTSD, etc), then you may also want to ask therapists about their experience treating clients who are dealing with these specific kinds of challenges.

How do I find therapists who specialize in insomnia?

Find vetted therapists with specific training in the treatment of sleep disorders on Zencare, below. Search by fees and location; watch therapist introductory videos; and book free initial calls to find the best insomnia therapist for you!

Note that many therapists who specialize in insomnia treatment have specialized training and education and are less likely to be in-network with health insurances. If you have trouble finding a therapist who takes your health insurance, consider applying for out-of-network benefits from your health insurance to offset the cost of treatment.

Curious to learn more? Read on for what to expect in a CBT for insomnia, symptoms of insomnia, and CBT for insomnia.