My struggles with insomnia began in my teens. I remember earnestly, pathetically, telling an old history teacher: “If I am yawning, it is not because I am bored, it is because I can barely sleep.” Her response was well-intentioned but ultimately futile: “Have you tried a warm bath?” This was the first of many pieces of advice that, while kind, couldn’t solve the deepening chasm between me and sleep. Night after night, I was left to stare at the ceiling until the early hours, my pulse racing as if I were being hunted for sport. A warm bath wasn’t going to cut it.
After the birth of my son, my insomnia reached a brutal peak. The combination of new-mother anxiety and unrelenting wakefulness had me fearing that I might never sleep again. My problem wasn’t just waking up in the night—it was the sheer inability to fall asleep in the first place. I felt like my mind had become allergic to rest. That’s when I stumbled upon Cognitive Behavioral Therapy for Insomnia (CBT-i), described as a ‘radical’ and ‘gruelling’ new approach to fix the most stubborn kinds of sleeplessness. Intrigued and desperate, I decided to give it a shot.
CBT-i promised to retrain my mind to accept and embrace sleep. Unlike medication, which only treats the symptoms, CBT-i is structured to address the underlying issues causing insomnia, teaching you how to cultivate healthy sleep habits long term. Foremost among its techniques is sleep restriction, a process that sounded utterly counterintuitive. The idea is to consolidate sleep by limiting the number of hours you’re allowed to be in bed, thus making you so tired that you can’t help but fall asleep.
The first few nights of sleep restriction were punishing. I was only permitted to be in bed for five hours. This harsh regimen meant I had to meticulously plan late-night activities that could keep me awake until my designated bed time. Inevitably, the short sleep windows left me even more exhausted the following day, a zombified version of myself stumbling through the waking hours. But this was all part of the plan: by severely curbing my sleep opportunities, I was training my mind and body to maximize those precious few hours I was allowed.
Resisting the temptation to nap during the day became an added challenge. My body craved rest, yet CBT-i demanded I deny it. On numerous occasions, I found myself nodding off at inappropriate times—during meetings, while reading a book, even during conversations. To combat this, I took up engaging activities that weren’t too relaxing, like light exercise or walking outdoors. These strategies helped me push through the sleep deprivation without cheating the therapy.
Gradually, something incredible began to happen. The built-up exhaustion started to make my sleep periods deeper and more restorative. Where once I would have lain awake for hours, I now found myself drifting off shortly after my head hit the pillow. The improvement in sleep quality became evident not just in my nights but also in my days. My mood lifted as the fog of fatigue began to clear, and my energy levels became more consistent. The punishment of those initial nights was starting to pay off.
A vital part of the CBT-i protocol involved ‘stimulus control,’ which entailed developing strong mental associations between my bed and sleep. Previously, my bed had been a place for reading, watching TV, and even eating. Through stimulus control, I learned to reserve the bed strictly for sleep and intimacy. Any time I couldn’t fall asleep within 20 minutes, I had to get up and engage in a quiet, non-stimulating activity until I felt sleepy again, reinforcing the bed-sleep connection.
Tracking my progress became another cornerstone of the CBT-i approach. I kept a meticulous sleep diary, noting the times I went to bed, how long it took to fall asleep, how many times I woke up, and what time I got up in the morning. This data was invaluable, as it helped me and my therapist monitor my improvement and adjust the program as needed. It also provided a sense of accomplishment, as the gradual progress became clearly visible over time.
Within a few weeks, my relationship with sleep had profoundly changed. The intense anxiety that used to grip me every evening started to lose its hold. I stopped dreading bedtime and instead approached it with a sense of calm and routine. While the process had been gruelling, the perseverance began to pay off as insomnia loosened its grip on my life. My ability to function, both as a mother and as a novelist, improved significantly with the steady reintroduction of rested, restorative nights.
In hindsight, I realize that adult sleep problems are rarely solved by simple solutions. The well-intentioned advice I received, from warm baths to herbal remedies, never addressed the root causes of my insomnia. It took a methodical and, yes, punishing approach to unlearn years of bad habits and anxiety related to sleep. CBT-i offered a holistic approach that not only tackled my immediate inability to sleep but also equipped me with tools to maintain healthy sleep habits for life.
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