Bregman Medical Group | Services

Sleep Therapy| Insomnia Therapy

Most, if not, all of us have tried losing a good night’s sleep. Perhaps you might have had trouble sleeping in the past due to a work deadline you needed to catch or a school presentation you were anxious about, and this left you still feeling tired and sleepy the next day. Losing even just one night of our precious sleep or having low quality sleep can already make us more irritable and stressed during the day, how much more for people who experience sleep disorders? Thankfully, sleep therapy can help.

Are you looking for “sleep therapy near me”?

Having insomnia and other sleep disorders has been linked to mental health disorders. In fact, 50 to 80% of clients in psychiatric practice report having experienced sleep problems at one point. Bregman Medical Group is composed of psychiatrists/ psychologists who specialize in diagnosing and treating mental health disorders that can be related to sleep problems such as depression and anxiety.

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What is insomnia?

Insomnia is a sleep disorder characterized by difficulty falling asleep, staying asleep, waking too soon from sleep, or still feeling tired even after getting the right amount of sleep. Because of having poor sleeping behaviors and quality, people with insomnia usually experience impaired daytime functioning - that is, they feel sluggish, they are easily distracted and find it hard to concentrate on a task, or feel moody. Insomnia is more common than you think. In fact, up to 50% of adults experience insomnia symptoms at some point in their lives, and it affects women more than men.

There are many causes of insomnia and it can affect both men and women. Some of the most common causes of insomnia are anxiety, depression, drinking too much caffeine or alcohol before going to bed, and jet lag. Having sleep problems may also be caused by certain medications that you are taking or another underlying health problem.

Cognitive behavioral therapy for insomnia (CBT-I)

Cognitive behavioral therapy for insomnia (CBT-I) is a structured program that combines cognitive, behavioral, and psychoeducational techniques to help clients assess and change certain thoughts and behaviors that negatively affect their sleep. With CBT-I, the therapist also helps the client to form good habits that promote good sleep quality.

CBT-I not only looks at the short-term treatment but also aims to treat the underlying root cause for a person’s insomnia. For this reason, it is highly recommended by therapists as the first line of treatment for patients with long-term sleep problems.

CBT-I: So how does it work?

Just like the usual CBT method used in therapy, CBT-I helps you examine and modify your attitudes and behaviors that affect your sleeping patterns. Sleep therapy recognizes how our thoughts and actions affect our quality of sleep.

  • Cognitive: Many people with insomnia excessively worry about their inability to fall asleep, so sleep therapy helps them develop ways to control their anxious thoughts for them to sleep better.

  • Behavioral: Your sleep therapist helps you gradually form good behavioral patterns that promote better sleep.

  • Educational: CBT-I also aims to educate the person on the benefits of having good sleep.

Here are some CBT-I strategies that sleep therapists use. They can be done alone or in combination to make therapy more effective:

  • Stimulus control therapy - In this technique, you will need to set a strict schedule for your bedtime and wake time. To help you stick to your schedule, you only use the bed for sleeping and avoid taking naps during the day.

  • Sleep restriction - If you have difficulty sleeping, you are to leave the bed instead of lying awake, and then lessen the amount of time you spend on the bed. Once your sleeping habits are improved, your time on the bed will also be increased.

  • Sleep hygiene - This technique involves a change in your lifestyle habits that are negatively affecting your sleep. Your therapist will gradually help you to eliminate counterproductive behaviors such as smoking, drinking too much caffeine or alcohol, or not getting enough exercise.

  • Sleep environment improvement - As the name suggests, this technique will help you create a more conducive environment for sleeping. To improve your sleep quality, you can keep your bedroom dark by using black-out curtains, avoiding using gadgets inside your bedroom, or hiding the clock from view.

  • Relaxation techniques - Relaxation techniques like sleep meditation, imagery, breathing exercises, and muscle relaxation can help you lessen or eliminate anxious thoughts related to sleep

  • “Paradoxical intention” - This method is when you avoid any effort of falling asleep when you cannot sleep. Avoiding effort can help you let go of your worry of not getting enough sleep ad paradoxically helps you relax and make it easier to sleep.

  • Biofeedback - This includes using devices that observe biological signs such as your heart rate and muscle tension and show how to adjust them. You can use a biofeedback device at home to record your daily patterns so you can help identify patterns that affect your sleep.

Sleep therapy and sleep medication: What’s the difference?

Sleep therapy is a great treatment for people who are worried about the risk of being too dependent on sleeping pills and their side effects. Sleep medications can be effective in the short term. They provide us immediate relief when we have difficulty sleeping due to stress and other factors. However, sleep medication may not be the best long-term treatment for insomnia because of its side effects (for example they are highly addictive and can cause memory problems).

Here is where CBT-I steps in. CBT-I can be very effective in treating long-term sleep problems compared to medication. CBT-I can also help with more than just relieving the symptoms of your insomnia, but also addresses its underlying causes.

So why is it important to treat insomnia?

Sleep is very important for our bodies to feel rested and alert, as well as to help the brain flush out toxins that can be harmful to us. When we do not get enough sleep all the time, we develop an increased risk of many physical and mental health conditions like high blood pressure, heart disease, Alzheimer’s disease, diabetes, depression, and anxiety.

When we don’t get enough sleep or we have disturbed sleep all the time, our cognitive function is also impaired - we have difficulty making rational decisions, difficulty learning, focusing, and solving problems.

If you are experiencing symptoms of insomnia, it is possible that there may be underlying mental health issues that are contributing to them. Contact our staff to know how therapy can help your mental health.

Is CBT-I effective?

Research shows that Cognitive Behavioral Therapy for Insomnia is the most effective nonpharmacological treatment of chronic insomnia. In addition, the benefits that patients get from CBT-I have been shown to last even after therapy is completed. These benefits include having less time to fall asleep and waking up less during sleep. CBT-I can also be effective for pregnant women as shown in this research, and can also benefit people who have post-traumatic stress disorder.

How much sleep do adults need?

According to the CDC, our ideal amount of sleep changes as we age. The American Academy of Sleep Medicine and the Sleep Research Society recommends around ten to sixteen hours of sleep for infants and young children, and eight to twelve hours of sleep for school-aged children and teenagers.

While some adults only need around six hours of sleep to feel energized for the day, most adults ideally need seven to eight hours of sleep to feel properly rested.

What are the stages of sleep?

According to sleep experts, our brain undergoes four stages of sleep, with each stage carrying a distinct role. Scientists use an electroencephalogram (EEG) to measure a person’s brain activity while they are sleeping.

Here are the 4 stages of sleep:

  • NREM Stage 1 - this is the stage where your brain is still transitioning from being awake to sleeping and lasts up to 10 minutes. Although your brain is still fairly active, it begins to slow down as your heartbeat and breathing also slow down and this makes your body more relaxed.

  • NREM Stage 2 - This stage usually lasts around 20 minutes per sleep cycle as your body becomes even more relaxed. There is a drop in body temperature, a stop in eye movements, and your breathing becomes more regular. This is also the stage where sleep spindles are produced by the brain to consolidate the memories you had from the previous day.

  • NREM Stage 3 - During this stage, we start to enter deep sleep as the body begins to repair itself. It will be more difficult for the person to wake up from noise or any stimulation from the environment. Our muscles and breathing are fully relaxed during this stage as our blood pressure drops.

  • REM Sleep - REM sleep happens around 90 minutes after sleeping, and it is during this stage that our brains become active, but despite the brain being active, our voluntary muscles are paralyzed and our body remains relaxed. It is during this stage when we dream, our eyes rapidly move, and our breathing becomes irregular.

These stages repeat several times in a cycle, with each cycle lasting longer and deeper.

The benefits of a good sleep

Sleep is very important and we get a lot of benefits from having a good night’s sleep!

Good sleep can help:

  • Boost our immune system and protect us from illnesses

  • Regulate our weight

  • Lower feelings of stress

  • Keep our focus during daytime activities

  • Retain learning and memory

  • Regulate our emotions well

  • Lessen our risk for physical problems such as diabetes and heart disease

Other Sleep Disorders

Aside from insomnia, here are other common sleep disorders that are worth noting:

Sleep Apnea

Sleep apnea is when a person pauses breathing during sleep, and this can be a serious medical condition because there is less oxygen intake in the body. One can either have obstructive sleep apnea where a person has a complete or partial obstruction to the airways that cause them to briefly stop breathing or central sleep apnea where the brain may have problems signaling one’s muscles to breathe during sleep.


Narcolepsy is when a person suddenly feels extremely tired and uncontrollably falls asleep during the day and during any activity. It is considered a long-term neurological condition since it is caused by the loss of hypocretin, which is a neurotransmitter that helps in regulating our sleep/wake cycle. Narcolepsy is primarily treated through medication.


A person with parasomnia can do unusual activities like talking and walking while asleep or when waking up from sleep. They have difficulty maintaining sleep through the night and may feel confused and tired when they wake up. Parasomnias include sleepwalking (also called somnambulism), bed-wetting (also called sleep enuresis), sleep talking, groaning, making aggressive noises and movements while asleep, and experiencing nightmares, sleep terrors, and sleep paralysis.

Restless leg syndrome

Restless leg syndrome is when a person has a sudden and irresistible urge to move their legs around. Since RLS usually happens during nighttime, it can affect a person’s sleep. People with RLS experience a distressing sensation that uncontrollably makes them want to move their legs when they are in a resting position (sitting or lying down). Doing these actions keep relieves them from feeling the sensation.

9 Habits to improve your sleep

If you have difficulty sleeping, here are some tips to help you.

  1. Don’t use your bed for anything else other than sleeping and intimate relations.
  2. If you have a busy day for the next day, make a to-do list early in the evening so that you’ll avoid worrying about what you need to do for the next day.
  3. To help you clear your mind, you may perform deep breathing exercises (or any relaxation/ meditation techniques of your choice) before bedtime.
  4. Limit your alcohol and caffeine intake.
  5. Avoid eating heavy meals at night,
  6. Don’t take naps during the day (or especially during the late afternoon and early evening).
  7. Get regular exercise, ideally in the morning.
  8. Use a sleep diary to keep notes of your sleeping patterns. Being aware of these patterns will help you change bad habits that can contribute to your difficulty sleeping.
  9. Make sure your bedroom promotes good sleep. You can avoid sunlight from entering the room by using blackout curtains; if you are a light sleeper and wakes at the softest sound, you can use earplugs to help you; if you like to sleep with the lights on, you can opt to use a sleep mask. Getting rid of gadgets in your room and keeping a consistent bedtime routine will also help you.

Establishing and following these habits will surely help you improve your overall sleep quality

Bregman Medical Group

Bregman Medical Group offers online telemedicine and teletherapy to new and existing patients. Click here to find out about the mental health services we offer. We look forward to helping you!

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By BregmanMD | January 20, 2022 | Mental Health

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