Since the 1970s, the term ‘sleep hygiene’ has circulated in sleep medicine laboratories and now permeated into the public consciousness. As more people experience insomnia while trying to lead healthier, more balanced lives, their sleeping habits become relevant.
Sleep hygiene, known as a set of recommended behaviors and environmental modifications that promote healthy sleeping patterns, is an effective and holistic way to optimize rest. However, when looking to treat mild to severe cases of insomnia, additional behavioral and thought modification techniques will be required. These practices demand dedication and consistency, which may be a reason why sleeping medication is increasingly chosen as the first line of defense for insomnia.
Dr. Olivia Beresford, an anesthetist and longevity medicine specialist, hopes to bring Cognitive Behavioral Therapy for Insomnia (CBT-I) to the forefront of discussions on insomnia and related disorders. In addition to incorporating these habits, she aims to raise awareness about how CBT-I can treat the underlying causes of this condition. This differs from the popular use of medications, which externalize the potential root cause when, in reality, insomnia results from anxious thoughts and maladaptive behaviors to restore sleep.
Sleep hygiene practices focus on increasing the body’s desire to rest by limiting harmful behaviors and fostering a conducive sleeping environment. A regular sleep schedule, including on the weekends, is key to building healthier sleep patterns. Without a set sleeping routine, the body can’t synchronize circadian rhythms, resulting in lower-quality sleep.
Many people are unaware of how behaviors practiced several hours before bedtime can delay the onset of sleep and reduce the quality of their rest. The body is very sensitive, making it critical to avoid specific activities that disrupt melatonin production and circadian rhythms. Some of these things include avoiding heavy meals, alcohol, nicotine, and caffeine close to bed. Additionally, exposure to devices using blue light–phones, computers, and televisions–should stop at least a few hours before resting. Physical exercise and anxious thoughts close to bedtime can also inhibit a person’s ability to fall asleep.
A sleeping environment is almost as important as the mindset one has toward rest. Since the body needs to enter deep levels of relaxation to fall and stay asleep, the place where someone rests is very relevant. Sleeping environments should be peaceful, dark, and quiet.
Although positive sleep hygiene can be very beneficial for achieving better rest and optimizing sleep, some people require alternative solutions. Dr. Olivia Beresford, an anesthetist and longevity medicine specialist, recognized this need after personally experiencing insomnia and supporting clients facing similar issues. Her medicinal background informed her of the critical importance of nutrition, sleep, and exercise in promoting physical and emotional well-being. However, it wasn’t until she sought more effective solutions that she discovered how CBT-I can address the underlying causes of insomnia.
I found a training program through Harvard on CBT-I and eventually developed a practice I have used to help myself and hundreds of clients overcome sleep difficulties.”
CBT is a well-known psychotherapy treatment used to improve mental health conditions by examining the connection between thoughts, feelings, and behaviors. Practitioners help clients confront negative thinking patterns and find practical solutions through structured sessions. This therapeutic approach has been used with insomnia patients for more than 50 years after psychologist Richard Bootzin introduced stimulus control therapy, a fundamental component of Cognitive Behavioral Therapy for Insomnia (CBT-I).
CBT-I has proven to be more effective than sleeping medication in the long term. Insomnia patients have improved their total sleep time and reduced sleep onset latency through this practice. CBT-I also has a lower risk of adverse side effects, such as dependency and tolerance issues associated with long-term sleeping medication usage. Overall, CBT-I addresses the root cause of insomnia, resulting in the treatment being effective in the long term. In fact, CBT-I is the recommended first-line treatment for insomnia, rather than medications, according to the American Academy of Sleep Medicine.
In Dr. Beresford’s experience, CBT-I has offered positive results for people with mild to severe cases of insomnia. Generally, an improvement in sleep hygiene is enough for someone with healthy sleeping patterns to limit occasional bouts of insomnia. However, CBT-I comes in handy for those who face larger, more persistent sleep interruptions.
“CBT-I has helped countless clients achieve deeper, more restful sleep,” Dr. Beresford says. “Many people have anxiety about not being able to sleep, which fuels the negative behaviors preventing them from doing so. CBT-I enables people to confront these problems and cultivate a more positive mental attitude toward sleep. However, sleep hygiene and CBT-I treatment both require commitment and time to show positive results.”
The consequences of insomnia and sleep deprivation can be severe. In the worst cases, these issues can lead to an increased risk of developing neurodegenerative diseases like Alzheimer’s and other chronic health conditions. Developing positive sleep hygiene is one of the most effective ways to avoid the negative outcomes of persistent low-quality sleep. If these habits don’t provide long-term results, CBT-I can be a valuable treatment used in conjunction with sleep hygiene practices.
