AARP Eye Center
If bedtime’s a battle with insomnia instead of a refreshing slide into dreamland, here’s news: A short course of therapy — in person, over the phone or online with video — can retrain your brain for better sleep. “Cognitive behavioral therapy for insomnia [CBT-I] is as effective as sleeping pills in the short term and more effective in the long term,” says Michelle Drerup, a sleep psychologist at the Cleveland Clinic Sleep Disorders Center. “It addresses the factors behind insomnia rather than putting a Band-Aid on it.”
For many, it works. Six CBT-I sessions helped more than 60 percent of people in their 30s through 60s with insomnia get improvements like falling asleep faster, waking up less often, logging more sleep and feeling less tired and anxious during the day in a 2020 University of Michigan study. A 2021 study of 29 people in their 60s through 90s found similar results, researchers from the Icahn School of Medicine at Mount Sinai report. The findings are noteworthy for older adults, who face a higher risk for sleep problems and make frequent use of prescription and over-the-counter snooze aids that raise risk for confusion, falls, urinary trouble, constipation and even memory problems. Other recent studies find it works for insomnia in cancer survivors, during menopause and in people with chronic arthritis pain — and can slash risk for insomnia-related depression by 51 percent in older adults, too.
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Yet CBT-I may be the best-kept secret in sleep medicine.
“Often, people aren’t aware it exists,” says J. Todd Arnedt, professor of psychiatry and neurology, director of the Behavioral Sleep Medicine Program at the University of Michigan and author of that 2020 study. Research suggests that primary-care doctors may not know about CBT-I or may think people aren't interested in it, even though two major medical groups, the American College of Physicians and the American Academy of Sleep Medicine, recommend it as first-line treatment for chronic insomnia. And people may mistakenly think it will mean months hashing out their feelings on a therapist’s couch. “It’s very different than talk therapy,” Drerup notes. “CBT-I is much more goal-directed. You’re learning a set of skills.”