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Our Calgary Psychologist Clinic’s therapists are experienced in CBT-i and help our clients to find ways to improve their sleep. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a psychological treatment approach that has gained recognition for effectively addressing the challenges associated with insomnia. With the guidance of a psychologist, CBT-I aims to modify negative thought patterns and behaviors that contribute to sleep difficulties, helping individuals regain control over their sleep patterns and improve overall sleep quality.
The core principles of CBT-I revolve around identifying and addressing the underlying causes of insomnia. This therapy recognizes that psychological factors such as anxiety, stress, and negative thought patterns can perpetuate sleep disturbances. By targeting these factors, CBT-I assists individuals in developing healthier sleep habits and reducing the frequency and intensity of insomnia symptoms.
CBT-I typically begins with a comprehensive assessment by a psychologist to understand the unique factors contributing to a person’s insomnia. This assessment may include an evaluation of sleep patterns, bedtime routines, lifestyle factors, and emotional well-being. With this information, the psychologist tailors the treatment plan to suit the individual’s specific needs.
One common technique used in CBT-I is stimulus control therapy. This approach aims to strengthen the association between the bed and sleep while breaking the association between the bed and wakefulness. It involves creating a sleep-friendly environment, establishing consistent sleep and wake times, and avoiding stimulating activities in bed. By reshaping these associations, individuals can experience a more restful and consistent sleep pattern.
Another key component of CBT-I is sleep restriction therapy. This technique helps regulate the sleep-wake cycle by initially limiting the amount of time spent in bed. Gradually, as sleep efficiency improves, the time spent in bed is increased. This process helps individuals consolidate their sleep, reduce time spent awake in bed, and strengthen the connection between bedtime and sleep.
Cognitive therapy is also an essential element of CBT-I. It focuses on challenging and reframing negative thought patterns and beliefs related to sleep. By replacing these thoughts with more positive and accurate ones, individuals can reduce anxiety, improve sleep quality, and develop a healthier mindset around sleep.
Additionally, relaxation techniques and sleep hygiene education are often incorporated into CBT-I. These techniques may include progressive muscle relaxation, deep breathing exercises, and strategies for creating a calming pre-sleep routine. Sleep hygiene education involves providing guidance on lifestyle factors that can impact sleep, such as exercise, caffeine intake, and exposure to electronic devices before bed.
CBT-I is recognized as an evidence-based treatment for insomnia and has shown promising results in numerous studies. It is often recommended as a first-line treatment option and can be effective as a standalone treatment or in combination with other interventions. By addressing both the cognitive and behavioral aspects of insomnia, CBT-I equips individuals with valuable tools and strategies to manage sleep difficulties and achieve long-term improvements in sleep quality and overall well-being.
Dr. Raheleh Tarani
Clinical Psychologist
English, Farsi, Japanese (basic), Hindi, Turkish, Punjabi, Urdu
Millions lie awake at night and watch the clock tick away. Sleep medications only give temporary relief, but CBT-I offers lasting solutions by targeting the mechanisms of sleep problems. This proven treatment blends behavioral changes, cognitive restructuring, and sleep education to help patients build healthy sleep patterns.
This complete guide shows how CBT-I works through its core parts and scientific proof. You’ll find the step-by-step treatment plan and learn what therapy involves. The guide also teaches you to put these tested strategies to work for better sleep.
Research shows how sleep disruption happens through complex interactions in the brain’s preoptic hypothalamus region. The brain’s glutamatergic neurons activate rhythmically during non-rapid eye movement sleep and affect overall sleep quality [1].
The Science of Sleep Disruption
Sleep problems affect between 33-50% of adults, while 7-18% have an insomnia disorder [2]. Poor sleep patterns can trigger several health problems. These include cognitive decline, weakened immune function, and metabolic disorders [3].
How CBT-I Changes Sleep Patterns
CBT-I helps the body’s natural sleep mechanisms work better through several key elements:
Proven Results
Research strongly supports CBT-I’s effectiveness. 70-80% of patients with primary insomnia see significant improvements [4]. Patients fall asleep faster, stay asleep longer, and wake up less during the night [4].
These benefits last up to 24 months after treatment ends [5]. Sleep duration keeps improving, and patients sleep about 50 minutes longer during follow-up periods [5].
Studies show CBT-I matches the effectiveness of sleep medication without side effects and has lower relapse rates [2]. The American College of Physicians now recommends CBT-I as the first treatment choice for adult patients [4].
Chronic insomnia creates psychological challenges that go way beyond the reach and influence of nighttime sleep difficulties. Research shows that approximately 50% of people with insomnia also struggle with a mental health condition [6].
Note that chronic insomnia affects many aspects of psychological well-being. Studies reveal 90% of people with major depressive disorder have insomnia-related sleep disturbances [7]. Mental health effects include:
The connection between sleep and anxiety creates a complex cycle. Research shows 50-80% of adults with mental health conditions struggle to fall or stay asleep in a typical year [7]. More than that, this two-way relationship means anxiety disrupts sleep and creates a sleep debt that makes anxiety symptoms worse [8].
Breaking free from chronic insomnia needs both psychological and behavioral changes. A patient’s psychological profile typically has obsessive thoughts, anxious tendencies, and ruminative personality traits [9]. Cognitive behavioral therapy helps patients spot and change unhelpful sleep-related thoughts. To cite an instance, see how thoughts like "I’ll be a wreck tomorrow if I don’t sleep" transform into more helpful points of view [10].
Research proves that changing these negative thought patterns brings exceptional improvements. This shows in the 87% success rate among CBT-I patients who keep their progress even after finishing treatment [11].
The standard cognitive behavioral therapy for insomnia follows a well-laid-out six-week timeline. Patients attend sessions weekly or bi-weekly [11]. A complete 60-90 minute pre-treatment assessment helps establish the patient’s baseline sleep patterns [11].
The treatment has these stages:
Most patients see major improvements in their sleep patterns by week four. Many say that "sleep is no longer a battlefield" [10]. Between weeks 4-6, patients feel less anxious about sleep and gain confidence in knowing how to keep healthy sleep patterns [10].
Multiple metrics show how well the treatment works. CBT-I reduces sleep latency from baseline averages of 60 minutes to approximately 30 minutes [12]. On top of that, wake-after-sleep-onset times drop by 22-37 minutes [13].
Success rates reach 70-80% during acute treatment [12], and patients keep these improvements for up to 24 months after treatment [12]. Research shows total sleep time gets better gradually after completing treatment [12]. Patients who finish the full protocol fall asleep more easily and wake up less during the night [10].
Cognitive behavioral therapy for insomnia has three main therapeutic components that target different sleep challenges. Studies show that standard CBT-I treatment delivers these components over six to eight sessions. These sessions typically last between 30 to 90 minutes [11].
Sleep restriction therapy helps increase sleep drive and improves sleep quality [11]. The approach matches bed time with actual sleep duration instead of limiting sleep itself. Someone who sleeps 6 hours but stays in bed for 9 hours would start with a 6-hour window [3]. The prescribed time should stay above 5.5 hours, regardless of how little someone sleeps [3].
Stimulus control therapy creates a stronger link between bed and sleep while reducing its connection to being awake. These guidelines work best:
Cognitive therapy tackles unhelpful thoughts about sleep that keep insomnia going. The process works through three steps:
This approach helps people develop better sleep expectations. Research shows that replacing thoughts like "I must get eight hours of sleep" with more realistic beliefs leads to less worry and better sleep [14].
CBT-I treatment success depends on individual-specific approaches. Research shows that about half of patients show most important improvement when they receive customized treatment plans [15].
Treatment starts with a complete sleep diary that tracks patterns for 1-2 weeks [16]. This vital baseline data helps therapists spot specific sleep patterns and create targeted interventions. Patients who track their sleep patterns before their original appointment often need fewer therapy sessions [15].
CBT-I’s flexibility makes it possible to modify treatment based on personal circumstances [15]. Treatment adjustments may include:
We focused on merging CBT-I elements into daily routines [17]. Sleep specialists help patients set realistic goals that line up with their life situations [4]. Research shows better adherence rates when there’s strong patient-therapist connection combined with personalized recommendations [18].
Therapists adjust the treatment as needed through continuous monitoring. They track progress using detailed sleep logs and make changes to get the best results [16]. This approach helps refine techniques, especially when patients move through different recovery stages [4].
A patient’s trip through cognitive behavioral therapy for insomnia starts with a detailed evaluation that takes 60-90 minutes [19]. During this original consultation, clinicians collect specific information about sleep patterns, medical history, and insomnia symptoms.
Sleep specialists explore a patient’s lifestyle factors, sleep hygiene habits, and conditions that might affect sleep quality [20]. This full picture helps create a tailored treatment approach. Specialists guide their patients to keep a daily sleep diary that tracks progress and spots areas needing work [19].
Patients run into several roadblocks during their CBT-I trip:
We tackled these challenges right away through shared problem-solving between therapist and patient. Studies show that up to 80% of people see improvement in their insomnia symptoms [19], and 90% cut down or stop using sleep medications [19].
Treatment progress shows up through several channels:
Most patients see improvements after 4-6 sessions [20]. Their anxiety about sleep drops and they feel more confident knowing how to maintain healthy sleep patterns. Therapists adjust treatment protocols based on each patient’s responses and challenges if expected progress stalls [5].
Research shows that cognitive behavioral therapy for insomnia delivers measurable improvements in many areas. Clinical studies track these results through standard assessment tools and follow-up evaluations over time.
The Insomnia Severity Index (ISI) works as the main measurement tool. Studies reveal average scores dropping from 18.3 to 10.1 after treatment [21]. Sleep efficiency typically improves by 8-16% [22], which creates better sleep patterns. The improvements include:
CBT-I for insomnia delivers substantial benefits beyond just better sleep. Studies show major improvements in physical functioning, social interactions, and mental health status [2]. Patients report better vitality and emotional well-being, with scores close to normal ranges after completing treatment [2].
CBT-I’s lasting effects prove its success. Studies following patients over time show that 64% no longer have insomnia symptoms at one-year follow-up [21]. These improvements stay stable, with 66% keeping their gains even after ten years [21].
Treatment responders achieve better outcomes in both sleep quality and psychological well-being [24]. Patients show better daytime functioning and less reliance on sleep medications [23]. Success rates vary among individuals, but 70-80% of patients achieve major improvements during initial treatment [12].
CBT-I shows remarkable results when patients pay attention to their environment and behavior. Studies reveal that consistent application of CBT-I principles helps 70-80% of patients sleep better [17].
Your sleep environment can make or break your treatment success. These elements are the foundations of good sleep:
Regular sleep patterns are the life-blood of long-term success. Patients who stick to regular sleep schedules show an 85% improvement in sleep efficiency [21]. These practices lead to lasting progress:
Sleep setbacks happen often, but good management keeps small disruptions from becoming big problems. We tracked sleep logs to spot triggers and patterns [27]. Research shows that people who keep consistent sleep records handle temporary sleep problems better [28].
Sleep specialists suggest these time-in-bed adjustments based on efficiency:
Small adjustments and regular monitoring lead to success. Patients who follow these guidelines typically keep their sleep improvements for up to 18 months after treatment [28].
CBT-I has proven to help people who don’t sleep well. Research shows it works – patients sleep 50 minutes longer and fall asleep 30-45 minutes faster than before.
CBT-I’s power comes from its complete approach. It combines sleep restriction, stimulus control, and cognitive restructuring techniques. These methods tackle both the mental and behavioral sides of insomnia. Patients see improvements that last up to 2 years after they finish treatment.
Each patient’s treatment plan matches their sleep patterns and daily routine. This individual-specific approach helps explain why 87% of patients who finish the six-week program see results.
Better sleep does more than just improve nights. Patients feel better physically, socially, and emotionally. CBT-I stands out as better than sleep medications because it offers lasting results without side effects or addiction risks.
Results tell the story clearly – CBT-I helps people sleep better and live better. Patients who keep sleep logs and stick to their treatment guidelines see major improvements. They break free from endless sleepless nights and get back to natural sleep patterns.
Q1. How quickly can patients expect to see results from CBT-I? Most patients begin to experience improvements in their sleep within 2 to 3 weeks of starting CBT-I. Significant progress is typically observed by the fourth week of treatment, with many reporting that "sleep is no longer a battlefield."
Q2. What is the overall success rate of CBT-I for treating insomnia? CBT-I has a remarkably high success rate, with 87% of patients achieving significant sleep improvements within six weeks. Studies show that 70-80% of patients with primary insomnia experience notable improvements, and these benefits can last for up to 24 months after treatment completion.
Q3. How does CBT-I compare to sleep medication for treating insomnia? CBT-I produces equivalent results to sleep medication but without side effects and with fewer episodes of relapse. It’s considered a superior alternative as it offers lasting solutions without the risks of dependency associated with sleep medications.
Q4. What are the core components of CBT-I treatment? The core components of CBT-I include sleep restriction to increase sleep drive, stimulus control to reclaim the bedroom for rest, and cognitive restructuring to address unhelpful thoughts about sleep. These elements work together to address both psychological and behavioral aspects of insomnia.
Q5. Can CBT-I help with other aspects of life beyond sleep? Yes, CBT-I not only improves sleep quality but also enhances overall quality of life. Patients report significant improvements in physical functioning, social interactions, mental health status, vitality, and emotional well-being. These benefits often approach normal ranges after treatment completion.
[1] – https://www.umassmed.edu/globalassets/psychiatry/cbti/overcoming_insomnia_session_2.pdf
[2] – https://jcsm.aasm.org/doi/10.5664/jcsm.3624
[3] – https://stanfordhealthcare.org/medical-treatments/c/cognitive-behavioral-therapy-insomnia/procedures/sleep-restriction.html
[4] – https://pmc.ncbi.nlm.nih.gov/articles/PMC4294319/
[5] – https://beckinstitute.org/blog/how-to-know-if-therapy-is-working/
[6] – https://www.sleepfoundation.org/insomnia/is-insomnia-a-mental-illness
[7] – https://www.healthline.com/health/insomnia/is-insomnia-a-mental-illness
[8] – https://www.sleepfoundation.org/mental-health/anxiety-and-sleep
[9] – https://pmc.ncbi.nlm.nih.gov/articles/PMC3972485/
[10] – https://pmc.ncbi.nlm.nih.gov/articles/PMC6796223/
[11] – https://pmc.ncbi.nlm.nih.gov/articles/PMC10002474/
[12] – https://pmc.ncbi.nlm.nih.gov/articles/PMC8808745/
[13] – https://bjgp.org/content/69/686/e657
[14] – https://www.umassmed.edu/globalassets/psychiatry/cbti/overcoming_insomnia_session_3.pdf
[15] – https://www.cbtiweb.org/ResourceFiles/FAQ-CBTIinPrimaryCare_07152021123109703.pdf
[16] – https://www.mayoclinic.org/diseases-conditions/insomnia/in-depth/insomnia-treatment/art-20046677
[17] – https://www.sleepfoundation.org/insomnia/treatment/cognitive-behavioral-therapy-insomnia
[18] – https://onlinelibrary.wiley.com/doi/full/10.1111%2Fjsr.14023
[19] – https://www.sleephealthfoundation.org.au/sleep-disorders/cognitive-behavioral-therapy-for-insomnia-cbt-i
[20] – https://changeworkspsychology.com/what-to-expect-when-starting-cbt-i/
[21] – https://www.tandfonline.com/doi/full/10.1080/16506073.2021.2009019
[22] – https://bmcprimcare.biomedcentral.com/articles/10.1186/1471-2296-13-40
[23] – https://pmc.ncbi.nlm.nih.gov/articles/PMC3481424/
[24] – https://pmc.ncbi.nlm.nih.gov/articles/PMC4744149/
[25] – https://www.veteranshealthlibrary.va.gov/diseasesconditions/Sleep/142,41438_VA
[26] – https://bayareacbtcenter.com/cbt-i-tips-to-improve-sleep/
[27] – https://www.thegoodsleepmethod.com/post/cbt-i
[28] – https://jcsm.aasm.org/doi/10.5664/jcsm.7580
[29] – https://deploymentpsych.org/content/faqs-cognitive-behavioral-therapy-insomnia-cbt-i
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Our Calgary Psychologists and therapists offer counselling and formal psychological assessment services for individuals, couples, and families. We tailor these services to meet the unique needs of each client. Our goal is to support our clients in achieving their personal and relational goals.
We help families improve communication and solve problems. We also offer assessments for learning disabilities and ADHD. Our support extends to various mental health issues. Our support covers many mental health issues.
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We are here to help with individual therapy, couples counseling, or support for your child, teen or family. We offer counseling services in person and virtually. This makes it convenient and flexible for our clients to access our services. Whatever challenges you may be facing, we are committed to guiding you towards healing, growth, and greater well-being.
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Our psychologists and therapists draw from a variety of counselling frameworks and theories when working with clients. Learn more about the many different frameworks and theories our psychologists, therapists, and counsellors use.
Yes! We have several psychologists and therapists that offer Calgary Couples Counselling, Marriage counselling and relationship counselling. Check our Couples Counselling service page to see what therapists specialize in providing Couples Counselling in Calgary and Alberta.
Yes! We provide direct billing where we can, it depends on your insurance company and the credentials of the therapist. Sunlife is one of the insurers that do not allow us to do direct billing. For Provisional psychologists we usually can only direct bill for AB Blue Cross and Greenshield. For Assessment work like psychoeducational assessments, we do not provide direct billing. We charge the assessment at the start of the process and when finished, we provide a letter outlining the services rendered that you can submit to your insurer for reimbursement.
Yes! We have several therapists that speak multiple languages. Meet our team of psychologists and therapists to see what languages are available.
Our psychologists, counsellors and therapists will, at minimum, have a Master degree in a related field. Many are registered psychologists or provisional registered psychologists who are with licensed with the College of Alberta Psychologists and some are Canadian Certified Counsellors who are registered with the Canadian Counselling and Psychotherapy Association See our therapists’ bios for detailed information about their credentials.
Our therapists are skilled in a variety of therapeutic frameworks. The most common framework is CBT, but all of our therapists are experienced in at least several frameworks and most are eclectic in the interventions they use, opting to use what works for the client instead of a adhering strictly to a single framework. Each therapist has the types of therapy they use listed on their profile page, and we also have a frameworks section that will list the therapists that use those frameworks on them.
Beyond frameworks, we offer Child, Youth, Couples/Marriage, and Individual counselling for men, women, seniors, and lgbtq identified individuals.
Yes! We have an office located across from Mount Royal University in Southwest Calgary, close to where Crowchild Trail Meets Glenmore Trail, and one office located in Brentwood NW Calgary close to University of Calgary.
Unfortunately, we do not offer sliding scale fees. Our fees can be accessed on our pricing page.
Yes! We offer online video or phone counselling in Calgary and throughout Alberta and beyond. While some clients are not interested in video counselling, we do have excellent therapists who work exclusively online and all of our therapists who offer in-person sessions also offer online video counselling.
We recommend taking advantage of the free consultation option first – you’ll get a chance to meet your therapist and ensure that the relationship is going to be a good fit and that you both believe you’ll be able to benefit from the relationship ahead of spending any money.
If you’re certain you just want to go ahead and book a session, simply send us a text message with your first name, last name, and email address, or provide it through the contact form. We will get you setup in the booking system, send you the intake forms to complete, and when done, get you booked!
Same day turn-around is generally very rare – we are not a crisis treatment center so if you can’t wait a little bit, it’s best to try contacting the Distress Centre.
That said, it does happen that we can get clients in with a therapist right away if there is an opening or a cancellation – the biggest hold up is getting the intake forms completed.
Yes! We offer assessments for both Adults and Children, and we offer Psycho Educational Assessments, ADHD Assessments, and Cognitive Assessments / IQ Tests. See the pricing page for further details. All our assessments are conducted by a College of Alberta Registered Psychologist who specializes in assessment work.
We frequently get asked questions about how long it will take to see improvements. This is a really difficult question to answer and depends more on the client, the issues they are dealing with, and where they are at in their life than the therapist. Our main goal is to help educate our clients and provide them with the tools so that they can improve their lives and move beyond therapy.
Online video counselling *can* be every bit as effective as in-person counselling, but it really depends on the situation. For young children, online counselling is likely not going to be effective because it’s much more difficult to engage them. For people dealing with very difficult mental health issues, or who already believe that online counselling is not effective, it likely won’t be as effective as in-person. However, for many clients who are dealing with anxiety, depression, trauma, online counselling can be extremely effective and can be much more convenient for our busy schedules.
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