Insomnia: its effect on mental wellness and the role of CBT-I

In today's fast-paced world, quality sleep is more crucial than ever. However, Australians sleep on average 6.9 hours per night¹ , which is less than the recommended 8 to 9 hours for adults. 
 
For some of us, the difficulty of falling or staying asleep will be associated with insomnia, a sleep disorder that can lead to and be worsened by anxiety and stress. The good news is that insomnia treatments such as Cognitive Behavioural Therapy for Insomnia, or CBT-I, are highly effective and successful. Let's look at the connection between insomnia, mental wellness, and how CBT-I therapy works. 

How does sleep affect wellbeing

It is during sleep that the body repairs itself, making it essential for your health. However, for insomnia sufferers, getting quality sleep can be an endless struggle. Insomnia not only affects us physically, but it can lead to greater irritability and difficulties with concentration, attention, learning, and memory.² Research has also shown that there is a strong connection between insomnia, stress, and anxiety.^2,3

The effect of insomnia on mental health

Poor sleep can lead to poor mental health, and vice versa. People who get less than 5 hours of sleep a night are more likely to wake up anxious¹, leading to a negative loop that can snowball.  
 
More troublingly, insomnia has been linked to an increased risk of chronic medical conditions such as diabetes, hypertension, and heart disease.² And when it comes to mental health, countless studies have found that individuals with insomnia have a higher risk of developing anxiety and depression than those without the condition.^2,3,4

Treatment for insomnia

Establishing a healthy sleep routine is essential for all individuals, regardless of whether they have a sleep disorder or not. A good habit is to go to bed and wake up at the same time every day to maintain a healthy sleep-wake cycle. Sleep quality can be improved by creating a relaxing sleep environment, limiting screen time, and avoiding caffeine and alcohol before bed. 

As part of your sleep routine, it is important to find a relaxation technique that works best for you. People can improve the quality of their sleep with deep breathing exercises, progressive muscle relaxation, and guided imagery, which can help reduce stress and promote relaxation.  

CBT-I therapy

If you have tried establishing a healthy sleep routine and managing stress and anxiety on your own but still struggle with insomnia, it may be time to seek professional help.  

The most recommended therapy for insomnia is CBT-I², a clinically proven treatment that focuses on changing sleep-interfering behaviors and thoughts. It typically involves behavioural strategies such as sleep restriction, stimulus control, and relaxation techniques, as well as cognitive strategies like cognitive restructuring and mindfulness practices.² 

Several studies have shown that CBT-I is highly effective in treating insomnia and improving sleep quality and duration within four to six sessions. ^{2, 5} Moreover, CBT-I has been shown to have long-term benefits, with improved sleep quality and duration lasting up to two years after treatment.⁴ It has even been found to be more effective than medication for treating insomnia,⁵ and the benefits of CBT-I extend beyond improving sleep quality and duration to include improvements in mental health and quality of life.^2,3,4. 

Integrated Therapy

Integrated therapy or multiple approach therapy is a type of therapy that combines different types of therapy based on the patient's needs. While CBT-i is classified as a mindfulness practice approach to insomnia, many patients find it useful to combine their therapy. dietary sleep supplements such as chamomile, magnesium, and valerian are widely used on top of CBT-i as well as supplementing with yoga or added relaxation exercise. Even various sleep hygiene items such as a cooling mattress protector to keep your body comfortable through the night are used. These added practices might not be necessary but can help supplement and ease you into sleep. 

Insomnia, stress, and anxiety can have a significant impact on your mental and physical wellbeing.^3,4 If you suffer from insomnia, you should seek professional help and consider adopting a guided CBT-I program to improve your health.