Insomnia Archives - Page 5 of 5 - Dr. Charles Freeman - San Diego Insomnia and Sleep Problems Treatment

Peaceful bedroom with warm morning light and mountain views, representing natural sleep improvement through CBT-I without medication

Can CBT-I Help You Sleep Without Medication?

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Can CBT-I Help You Sleep Without Medication? By Dr. Charles R. Freeman, Ph.D. Yes, Cognitive Behavioral Therapy for Insomnia, or CBT-I, can help many people sleep with less reliance on medication. CBT-I teaches the brain and body how to return to natural sleep by changing the thoughts, behaviors, habits, and nervous-system patterns that keep insomnia going. Medication may help temporarily, but CBT-I addresses the causes of chronic insomnia rather than only sedating the symptom. That distinction is important. I do not tell patients to suddenly stop medication. Sleep medications, benzodiazepines, antidepressants, and other prescriptions should only be changed in coordination with the prescribing physician. My role is to help patients build skills so sleep does not depend entirely on an external substance. Many people start taking something for sleep during a difficult season: grief, trauma, anxiety, medical stress, work pressure, divorce, caregiving, or a period of major life disruption. At first, the medication may help. Over time, some patients begin needing more support from pills, supplements, alcohol, or strict rituals. They may sleep, but the sleep does not feel restorative. They may also start believing, “I cannot sleep on my own anymore.” What Is CBT-I? CBT-I is a structured treatment for chronic insomnia. It is not simply sleep hygiene, relaxation, or positive thinking. It is a practical method for retraining the sleep system. CBT-I looks at what the person does before bed, how much time they spend awake in bed, how they respond to nighttime awakenings, what they believe about sleep, and how much fear has become attached to not sleeping. In chronic insomnia, the bed often becomes associated with effort, frustration, clock watching, and fear. A person may feel sleepy in the living room, then become wide awake the moment they get into bed. That does not mean they are broken. It means the nervous system has learned a pattern. CBT-I helps change that pattern. Why Medication Alone Often Does Not Solve Chronic Insomnia Medication can sometimes provide short-term relief. The problem is that chronic insomnia is often the symptom, not the root cause. Underneath the sleep problem may be anxiety, trauma, PTSD, pain, depression, grief, over-responsibility, perfectionism, or a learned fear of being awake. Sedation and healthy sleep are not the same thing. Restorative sleep supports memory, mood, emotional processing, immune function, concentration, and physical recovery. Some patients describe medication-induced sleep as “fake sleep.” They were unconscious, but they wake up foggy, unrefreshed, anxious, or still afraid of the next night. CBT-I works differently. Instead of trying to knock the body out, it helps reduce the arousal that keeps the brain awake. It also helps patients rebuild confidence that their body can sleep naturally again. What Is CBT-I Not? CBT-I is not a list of generic tips. Many patients already know to keep the room dark, avoid caffeine late in the day, reduce screens, and maintain a consistent schedule. Those habits can help, but they are usually not enough when insomnia has become chronic. CBT-I is also not willpower. Patients with insomnia are often trying very hard already. In fact, trying harder can make sleep worse. Sleep does not respond well to pressure. The more a person tries to force sleep, the more the brain treats bedtime as a performance test. CBT-I is not about blaming the patient either. It is about identifying the patterns that are keeping the nervous system activated and then changing them in a careful, practical way. How Does CBT-I Help You Sleep Without Medication? CBT-I helps by addressing conditioned arousal. Conditioned arousal means the brain has learned to connect bed, bedtime, or nighttime waking with alertness. The person may begin monitoring sleep, checking the clock, predicting failure, and worrying about the next day. A normal awakening becomes an emergency. CBT-I teaches a different response. The patient learns how to reduce clock watching, decrease catastrophic thoughts, improve sleep timing, and stop reinforcing wakefulness in bed. Over time, the bed can become a cue for sleep again instead of a cue for effort. One of the most important shifts is changing the relationship with wakefulness. Waking up during the night does not mean the night is ruined. A bad night does not mean the body has failed. When the patient stops reacting to wakefulness as a crisis, the nervous system often settles more quickly. Can CBT-I Help If You Have Taken Sleep Medication for Years? Many people can improve after years of relying on sleep aids, but the process needs to be handled responsibly. If medication has been used for a long time, especially benzodiazepines or sedative hypnotics, any change should be coordinated with the prescribing physician. Stopping suddenly can be unsafe. The psychological work matters just as much. Long-term medication use can unintentionally teach the patient that natural sleep is impossible. CBT-I helps challenge that belief. The goal is not to rip away support before the person is ready. The goal is to build enough skill and confidence that sleep becomes less dependent on medication over time. What Happens During CBT-I Treatment? My approach is directive, collaborative, practical, and solution-focused. You are driving the car with your therapeutic goals, and I am the passenger helping guide the route. We look at what is maintaining the insomnia, create a treatment plan, assign practical homework, review what happened, fine-tune the tools, and continue adjusting until the changes become more sustainable. Treatment may include sleep scheduling, stimulus control, cognitive restructuring, relaxation training, hypnosis, guided imagery, breathing skills, and strategies for reducing sleep anxiety. If trauma, PTSD, nightmares, or hypervigilance are involved, treatment may also include EMDR or other trauma-focused work. If pain or medical symptoms are involved, we may coordinate with physicians or other specialists. CBT-I is not passive. The patient has to practice. The more energy the patient puts into the process, the more they usually get out of it. The goal is to leave the patient with tools they can use for the rest of their life. What I Often See in Practice I

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A tired adult sitting calmly in a softly lit bedroom at night, reflecting on chronic insomnia and sleep anxiety

What Causes Chronic Insomnia?

Active Duty Military and Dependents, Chronic Pain and Behavioral Medicine, Insomnia, Insomnia and Sleep Problems, PTSD, Sleep Psychology / admin

What Causes Chronic Insomnia? By Dr. Charles R. Freeman, Ph.D. Chronic insomnia is usually caused by more than one issue. Anxiety, trauma, PTSD, chronic pain, depression, grief, stress, medication dependence, alcohol use, medical symptoms, and learned patterns of nighttime alertness can all keep the brain and body awake. In many cases, insomnia is the symptom, not the root cause. That distinction matters. Many people try to solve insomnia by focusing only on the surface problem: the number of hours slept, the time they wake up, the medication they take, or the routine they follow before bed. Those details can matter, but chronic insomnia often continues because the nervous system has learned to stay on guard when it should be resting. Sleep is one of the foundations of health. I often describe exercise, nutrition, sound sleep, and meaning or purpose as four legs of the table. When one leg is unstable, the whole table starts to wobble. A person may have a successful career, strong discipline, good nutrition, and a meaningful life, but if sleep is falling apart, everything else becomes harder. Why Does Anxiety Cause Chronic Insomnia? Anxiety keeps the nervous system activated. At night, the mind may start reviewing conversations, predicting tomorrow, solving problems, scanning the body, or worrying about the consequences of another bad night. The person may be exhausted, but the brain is still behaving as if something urgent needs attention. This becomes especially difficult for high-functioning people. The same mental habits that help them perform during the day can work against them at night. They try harder. They analyze harder. They monitor sleep more closely. Bedtime becomes a performance test, and sleep does not respond well to pressure. Can Trauma or PTSD Cause Chronic Insomnia? Yes. Trauma is one of the most common contributors to chronic insomnia. Trauma teaches the body to stay alert. Even after the danger has passed, the nervous system may continue acting as if it needs to protect the person from threat. This can show up as difficulty falling asleep, waking in panic, nightmares, early-morning awakening, muscle tension, irritability, or a feeling that the bed is not emotionally safe. For some people, the trauma happened at night. For others, the trauma involved years of criticism, emotional unpredictability, military stress, abuse, caregiving pressure, or chronic fear. Trauma does not have to be one obvious event. Repeated exposure to threat, shame, loss of control, moral injury, or emotional invalidation can also train the body to stay vigilant. When that vigilance follows a person into bed, sleep becomes difficult. How Does the Bed Become Associated With Wakefulness? One of the most important causes of chronic insomnia is conditioning. If someone spends months or years lying in bed awake, frustrated, worried, or afraid, the brain can begin associating the bed with alertness instead of sleep. At that point, the person may feel sleepy on the couch but wide awake once they get into bed. They may start checking the clock, calculating how many hours are left, worrying about work the next day, or judging themselves for not sleeping. This does not mean the person is broken. It means the nervous system has learned a pattern. The encouraging part is that learned patterns can be unlearned. Treatment is not simply about giving the person more sleep tips. It is about retraining the brain and body so the bed becomes associated with sleep again instead of effort, fear, and frustration. Can Sleeping Pills Maintain Chronic Insomnia? Sleep medications may be appropriate in short-term situations, such as acute grief, medical crisis, or temporary stabilization. The concern is long-term reliance when the underlying causes of insomnia remain untreated. Benzodiazepines and sedative hypnotics may temporarily reduce anxiety or induce sleep, but some people experience rebound anxiety, rebound insomnia, tolerance, dependence, or sleep that feels non-restorative. A medication may sedate the body without teaching the nervous system how to sleep naturally again. Many patients describe a familiar pattern. A medication works at first. Then it works less consistently. Then the dose increases or additional substances are added, such as alcohol, over-the-counter sleep aids, or supplements. The person is not careless. They are desperate for relief. But when the root causes remain active, medication alone often cannot solve chronic insomnia. Can Pain, Depression, or Medical Symptoms Cause Insomnia? Chronic pain and insomnia often reinforce each other. Pain disrupts sleep, and poor sleep lowers pain tolerance the next day. Medical symptoms such as gastrointestinal distress, migraines, fatigue, neuropathy, or cardiac-like anxiety sensations can also increase nighttime arousal and fear about the body. Depression can disrupt sleep as well. Some people wake too early and cannot return to sleep. Others sleep many hours but still wake feeling unrefreshed. In both situations, treatment may need to address mood, behavior, activity level, thinking patterns, and physiological arousal rather than focusing only on bedtime habits. Why Is Sleep Hygiene Often Not Enough? Sleep hygiene can help, but it is rarely enough for chronic insomnia by itself. Many patients already know the basics. They have darkened the room, stopped caffeine late in the day, removed screens, bought a better mattress, and tried relaxation apps. Those habits are not wrong. They are just incomplete. If fear of wakefulness is driving insomnia, sleep hygiene will not fully solve it. If trauma is keeping the body alert, a cool bedroom will not be enough. If perfectionism, grief, pain, resentment, or over-responsibility is following the person into bed, treatment has to address those patterns directly. What I Often See in Practice In practice, I often meet people who are capable during the day and discouraged at night. They can lead teams, raise families, manage military responsibilities, care for others, and solve complex problems. Then they get into bed and feel helpless. That helplessness can become part of the insomnia cycle. A person wakes up and thinks, “Here we go again.” They check the clock. They predict the next day will be ruined. They become angry at their body. The awakening becomes an

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Woman waking up refreshed and energized after improving sleep through Cognitive Behavioral Therapy (CBT) and healthy sleep habits.

How Changing Your Behaviors Changes Your Sleep

Cognitive Behavioral Therapy (CBT), Insomnia, Sleep Psychology, Treatment for Sleep Disorders / admin

How Changing Your Behaviors Changes Your Sleep By Charles R. Freeman, Ph.D. You might be wondering, is it true that changing your behavior can affect your sleep? And the answer is “yes,” this result can be achieved by applying Cognitive Behavioral Therapy (CBT). CBT includes changing thoughts and behaviors around health, sleep, anxiety, depression, etc. Let’s say you tell yourself “I have to sleep tonight, or I’ll have a horrible night” or “I didn’t sleep last night, I HAVE to sleep well tonight.” You’ll have more positive results if you change these negative thoughts with Positive Psychology and mantras into what you WANT to manifest. I often start by teaching my patients and clients the correct behaviors around sleep (Sleep Hygiene) like: no alcohol right before sleep cool and dark enough room winding down prior to sleep Correct sleep hygiene behaviors are all over the internet and they are very helpful. By itself, it’s not sufficient for you to obtain sound sleep. In my practice, I also incorporate hypnosis and other energy work to heal a variety of health challenges. Insomnia is just the tip of the iceberg, it’s simply a symptom. The underlying issue might be trauma, complex types of anxiety conditions, depression, Type-A behavior, burning it at both ends and an unwillingness to wind-down prior to bed. It might also be grief and loss, and medical conditions like pain, thyroid over/under activation, CFS/Fibro, Lyme’s disease, Cancer, and more. I’ve had extensive positive results using these techniques as a psychologist and a wellness and executive coach. I’ve worked with executives going through all the above issues to create more balance and joy, and less anxiety, anger, and depression. This results in improved mental clarity and productivity, and an overall increase in the quality of life. About the Author Dr. Charles R. Freeman, Ph.D., is a psychologist specializing in insomnia, sleep disorders, PTSD, anxiety, trauma, and Cognitive Behavioral Therapy for Insomnia (CBT-I). He has more than 25 years of experience helping individuals improve sleep, emotional well-being, and overall quality of life through evidence-based treatment approaches. If you would like to learn more about treatment options or schedule a consultation, please contact Dr. Freeman. The information in this article is provided for educational purposes only and is not intended to replace professional medical or psychological advice. Individual circumstances vary, and readers should consult a qualified healthcare professional regarding their specific concerns.

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Middle-aged woman sleeping peacefully as a result of therapy for sleep without medication

Can Therapy Help You Sleep Without Medication?

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Can Therapy Help You Sleep Without Medication? By Dr. Charles R. Freeman, Ph.D. Yes, therapy can help many people sleep without relying solely on medication, especially when insomnia is being driven by anxiety, trauma, stress, pain, rumination, sleep fear, or learned patterns of nighttime alertness. Medication may provide short-term relief, but therapy addresses the patterns that keep insomnia going. That does not mean everyone should abruptly stop taking sleep medication. Medication changes should always be discussed with the prescribing physician. The goal of therapy is different. Therapy helps you understand why your sleep system feels stuck and teaches practical skills so your mind and body can become more confident about sleep again. Many people who struggle with sleep are not doing anything “wrong.” They are often working hard, taking care of others, functioning at work, and holding themselves together during the day. Then, when the house is quiet and the lights are off, the nervous system finally shows how much pressure it has been carrying. Why Doesn’t Medication Always Solve Insomnia? Sleep medication can be useful in certain situations, especially during an acute crisis, grief, medical stress, or a short period of severe disruption. The difficulty is that chronic insomnia often continues because the nervous system has learned to associate bedtime with alertness, fear, frustration, or pressure. Many people come to therapy after trying several sleep aids, supplements, prescriptions, podcasts, apps, special pillows, strict routines, and late-night internet searches. They are not careless. They are exhausted and trying to function. Underneath the practical problem is often a painful question: “What if my body cannot sleep on its own anymore?” That fear matters. When you begin to fear the bed, the clock, the next workday, or the feeling of being awake at 3 a.m., insomnia becomes more than a sleep problem. It becomes a conditioned alarm response. Medication may sedate the body, but sedation is not the same as restorative sleep. Restorative sleep requires the nervous system to stand down. What Kind of Therapy Helps to Sleep Without Medication? Cognitive Behavioral Therapy for Insomnia, or CBT-I, is the gold standard behavioral treatment for chronic insomnia. CBT-I is not simply sleep hygiene. Most people with chronic insomnia already know the basics: keep the room dark, reduce caffeine, avoid screens, and keep a consistent schedule. Those steps may help, but they are often not enough. CBT-I looks at the thoughts, behaviors, timing, and nervous-system patterns that keep insomnia active. It may include sleep scheduling, stimulus control, sleep restriction, reducing clock watching, changing catastrophic thoughts about sleep, and helping the bed become associated with rest again instead of struggle. Therapy may also include trauma treatment, EMDR, relaxation training, hypnosis, breathing skills, guided imagery, sensory grounding, cognitive reframing, and work on anxiety or emotional suppression. The right treatment depends on what is actually keeping the person awake. I want to know whether the insomnia is connected to grief, work pressure, pain, PTSD, anger, relationship stress, perfectionism, or years of overfunctioning. Why Does Trying Harder to Sleep Make Things Worse? Sleep is not a performance. It is a biological process that works best when the brain stops turning bedtime into a test. The harder a person tries to force sleep, the more the nervous system learns that wakefulness is dangerous. This is especially common in high-functioning people. The same discipline, analysis, problem-solving, and control that help someone succeed during the day can keep the brain activated at night. The person lies in bed trying to solve sleep. They monitor the clock, calculate how many hours are left, predict tomorrow’s failure, and judge the body for not cooperating. In therapy, we work on changing that relationship with wakefulness. The first target is often not sleep itself, but fear of not sleeping. When a person learns to wake up without escalating into panic, checking, self-criticism, or catastrophic predictions, sleep often becomes less brittle. Can Therapy Help If Trauma or PTSD Is Affecting Sleep? Yes. Trauma often shows up most clearly at night. A person may not have obvious flashbacks during the day, but may experience early-morning waking, nightmares, body tension, irritability, shame, anger, or a feeling that the body cannot stand down. After trauma, the nervous system may continue operating as if danger is nearby, even when life is objectively safer now. Some people were harmed at night. Some grew up in homes where conflict, criticism, or emotional unpredictability made rest feel unsafe. Some carried responsibility too early in life and learned to stay alert because relaxing did not feel wise. In these situations, sleeping pills may become an attempt to override a survival system that is still on guard. Therapy helps the nervous system learn safety again. Trauma-focused treatment needs pacing. EMDR and related approaches can be helpful, but patients also need grounding, stabilization, recovery skills, and a practical plan for what to do when symptoms intensify. What If I Wake Up in the Middle of the Night? Middle-of-the-night awakening is one of the most common problems I see. Many people fall asleep fairly well, then wake at 2 or 3 a.m. in a state of alertness. They may feel panic, pain, guilt, resentment, or a rush of planning. The effort to get back to sleep can become more disruptive than the awakening itself. Therapy teaches a different response. Waking up does not mean the night is ruined. A bad night does not mean treatment failed. Recovery often begins when the person stops treating every awakening as an emergency. For many patients, wakefulness is not the enemy. Panic about wakefulness is the enemy. The goal is to help the body learn, “I am awake right now, but I am not in danger.” That shift may sound simple, but it can be powerful when practiced consistently. What I Often See in Practice I often meet people who appear highly capable from the outside. They work, parent, lead, serve, solve problems, and take care of everyone else. Internally, they may be exhausted, anxious, angry, grieving, ashamed, or running

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Side effects of sleeping pills shown with common prescription sleep medications

What Are the Side Effects of Sleeping Pills?

Dangers of Prescription Drugs, Insomnia, PTSD, Sleep Psychology, Treatment for Sleep Disorders / admin

A decade ago, in 2010, the Drug Enforcement Agency spearheaded a nationwide initiative to take back unused prescription medications. This move aimed to heighten public awareness about the potentially lethal implications of prescription drug misuse. Despite these efforts, the prevalence of misuse and its consequences remain concerning.

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Effects of sleep deprivation on physical health, mental health, and daily functioning

Effects of Sleep Deprivation: How Sleep Disorders Affect Health

4 Comments / Insomnia, Sleep coach, Sleep Psychology / admin

Effects of Sleep Deprivation: How Sleep Disorders Affect Health By Dr. Charles R. Freeman, Ph.D. In my last post, I talked about the four main categories of sleep disorders. Let’s talk about the effects of sleep deprivation on your life. Sleep disorders can affect nearly every aspect of physical and mental health. The effects of sleep deprivation often begin with fatigue and difficulty concentrating, but ongoing sleep problems can contribute to serious health conditions over time. Understanding the effects of sleep deprivation can help people recognize when trouble sleeping has become a significant health concern and why early treatment matters. Why Healthy Sleep Matters Healthy sleep is essential for both the brain and the body. During sleep, the brain processes information, stores memories, regulates emotions, and prepares for the demands of the next day. A well-rested brain supports concentration, learning, decision-making, and emotional stability. The body also depends on sleep to maintain physical health. Sleep supports immune function, hormone regulation, metabolism, cardiovascular health, and tissue repair. When sleep is disrupted by insomnia, sleep apnea, circadian rhythm disorders, or other sleep disorders, these important processes may not function as effectively. Many people underestimate the importance of sleep until they begin experiencing sleep problems themselves. Sleep is not simply a period of rest. Sleep is an active biological process that supports overall health and well-being. Short-Term Effects of Sleep Deprivation The short-term effects of sleep deprivation can appear after only a few nights of poor sleep. Many people experience fatigue, irritability, difficulty concentrating, forgetfulness, slower reaction times, and reduced productivity. Tasks that normally feel simple may suddenly require much more effort and attention. Sleep deprivation can also affect emotional functioning. People who are sleep deprived often report increased stress, frustration, anxiety, and mood swings. Small problems may feel overwhelming when the brain is not receiving adequate rest. The effects of sleep deprivation can also create safety concerns. Reduced alertness and impaired judgment increase the risk of workplace accidents, household injuries, and motor vehicle crashes. Research has shown that severe sleep deprivation can impair performance in ways that resemble alcohol intoxication. Long-Term Effects of Sleep Deprivation The long-term effects of sleep deprivation can be even more serious. Chronic sleep deficiency places ongoing stress on the body and has been linked to a variety of medical and psychological conditions. Research suggests that chronic sleep deprivation may increase the risk of obesity, high blood pressure, heart disease, stroke, type 2 diabetes, and weakened immune function. Sleep deprivation consequences may also include increased inflammation throughout the body, which has been associated with many chronic health conditions. Sleep disorders and chronic sleep deficiency can also affect hormone regulation. Disrupted sleep may influence hormones that control hunger, appetite, metabolism, and stress responses. These changes can make it more difficult to maintain a healthy weight and support overall wellness. The lack of sleep effects often develop gradually, making them easy to overlook. Many people adapt to feeling tired and assume their symptoms are normal, even when chronic sleep deprivation is affecting their health. Sleep Disorders and Mental Health The connection between sleep and mental health is strong. Sleep disorders frequently occur alongside anxiety, depression, post-traumatic stress disorder, and other psychological conditions. At the same time, poor sleep can worsen the symptoms of these conditions. Many people become trapped in a cycle where emotional distress interferes with sleep and sleep deprivation increases emotional distress. Anxiety can make it difficult to fall asleep, while chronic insomnia can increase anxiety about sleep itself. Mental health and sleep deprivation influence one another in powerful ways. Research has shown that people who experience ongoing sleep problems are more likely to report symptoms of depression, anxiety, irritability, and emotional instability. Sleep disturbances can also reduce resilience and make it harder to cope with everyday stress. How Sleep Disorders Affect Daily Life Sleep disorders affect more than physical and mental health. They can also influence relationships, work performance, academic success, and overall quality of life. People who struggle with sleep disorders often report reduced motivation, lower productivity, and difficulty maintaining focus throughout the day. Sleep deprivation can affect memory, problem-solving abilities, and decision-making skills. These difficulties may create challenges at work, school, and home. Relationships may also suffer when sleep problems persist. Chronic fatigue, irritability, and emotional exhaustion can affect communication and reduce patience with family members, friends, and coworkers. Many individuals withdraw from activities they once enjoyed because they lack the energy to participate fully. Treatment Can Improve Sleep and Health The good news is that effective treatment options are available for many sleep disorders. Treatment depends on the specific diagnosis and underlying causes of the sleep problem. Many individuals benefit from Cognitive Behavioral Therapy for Insomnia (CBT-I), which is considered the gold standard treatment for chronic insomnia. Other treatment approaches may include sleep hygiene education, behavioral sleep medicine interventions, medical treatment, or strategies that address underlying mental health concerns. Addressing sleep problems early can reduce the effects of sleep deprivation and improve both physical and mental health. Better sleep often leads to improved concentration, greater emotional stability, increased energy, and a higher quality of life. Sleep Disorders Should Not Be Ignored Many people assume that poor sleep is simply part of modern life. In reality, persistent sleep problems deserve attention. Sleep disorders are medical and psychological conditions that can affect nearly every aspect of health and functioning. The effects of sleep deprivation can accumulate over time and contribute to serious physical and mental health consequences. Seeking professional help for ongoing sleep difficulties may be one of the most important steps you can take to protect your long-term health, improve daily functioning, and enhance your overall quality of life. About the Author Dr. Charles R. Freeman, Ph.D., is a psychologist specializing in insomnia, sleep disorders, PTSD, anxiety, trauma, and Cognitive Behavioral Therapy for Insomnia (CBT-I). He has more than 25 years of experience helping individuals improve sleep, emotional well-being, and overall quality of life through evidence-based treatment approaches. If you would like to learn more about treatment options or schedule a consultation, please contact Dr. Freeman. The

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Patient and therapist discussing treatments for sleep disorders

Four Common Treatments for Sleep Disorders

1 Comment / Cognitive Behavioral Therapy (CBT), Insomnia, Sleep coach, Sleep Psychology, Treatment for Sleep Disorders / admin

Four Common Treatments for Sleep Disorders By Dr. Charles R. Freeman, Ph.D. There are four treatments for sleep disorder that can help people improve sleep quality, daytime functioning, and overall health. These common treatments include sleep hygiene, Cognitive Behavioral Therapy (CBT), medication, and holistic approaches. Many individuals benefit from using more than one treatment approach at the same time. Understanding the available sleep disorder treatments can help you choose the most effective path toward better sleep. Sleep Hygiene for Better Sleep Sleep hygiene is defined as the various practices put into place to support healthy, quality nighttime sleep and full daytime alertness (National Sleep Foundation). It includes habits such as avoiding napping; decreasing or eliminating stimulants such as caffeine, nicotine, or alcohol; getting enough exercise; establishing a bedtime routine; and arranging the bedroom for optimal sleep (e.g., decreasing the temperature, eliminating unnecessary light, and removing technology devices). It can also include such practices as avoiding clock watching when in bed, exposing yourself to bright light or sunlight after waking, refraining from large meals before bedtime, and keeping a regular wake and bedtime schedule. While sleep hygiene can help the average person address general sleep difficulties, it alone is not sufficient to overpower the symptoms of major sleep disorders. With true sleep disorders, a combination of multiple treatment approaches earns the most effective results. Cognitive Behavioral Therapy (CBT) Cognitive Behavioral Therapy (CBT) looks at the relationships between your mind, body, emotions, behaviors, and illness. CBT is considered the gold standard of therapeutic care for treatment of sleep disorders such as insomnia. This therapeutic approach can help you make behavioral changes to improve sleep hygiene, while also changing thought patterns to decrease the catastrophic thinking, anger, frustration, or hopelessness that is common if you are struggling with sleep disorders. Therapeutic tools like sleep journals, cognitive restructuring, guided imagery, and hypnosis can help you gain objectivity about your sleep and grow out of the destructive narrative that leads to anger and worry. Medication Treatment for Sleep Disorders While some research argues that medications are not the most effective form of treatment, medications such as sedative-hypnotics are commonly used to treat sleep disorders. While they do increase your overall quantity of sleep, they do not always increase the quality of sleep. These medications can impact your brain chemistry and often leave you feeling groggy, foggy, unclear, and drained of energy, even after a full night’s sleep. They can also, over time, increase mortality risks. That being said, sedative-hypnotics may be helpful as a short-term treatment for sleep disorders, but therapeutic and holistic approaches to treatment are much more effective and safer. Holistic Treatments for Sleep Disorders There are several holistic treatments that can help you decrease or eliminate sleep disorders. For example, you can learn to use self-hypnosis or meditation at bedtime, which can not only help decrease your worry and anxiety, but also work to relax the sympathetic nervous system and increase your probability of falling asleep. Similarly, activities like regular exercise, acupuncture, and massage can also have positively impact on your body and mental state; decreasing symptoms of sleep disorders and resulting in greater sleep quality. About the Author Dr. Charles R. Freeman, Ph.D., is a psychologist specializing in insomnia, sleep disorders, PTSD, anxiety, trauma, and Cognitive Behavioral Therapy for Insomnia (CBT-I). He has more than 25 years of experience helping individuals improve sleep, emotional well-being, and overall quality of life through evidence-based treatment approaches. If you would like to learn more about treatment options or schedule a consultation, please contact Dr. Freeman. The information in this article is provided for educational purposes only and is not intended to replace professional medical or psychological advice. Individual circumstances vary, and readers should consult a qualified healthcare professional regarding their specific concerns.

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Man lying in bed at night using his phone, with blue screen light, a common cause of poor sleep

Common Treatments for Sleep Disorders

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Common Treatments for Sleep Disorders Sleep disorder treatments fall into a variety of categories, including sleep hygiene, psychotherapy, medications ranging from mild over-the-counter sleep aids to powerful sleep sedatives and hypnotics, and holistic approaches. It is not uncommon for two or more treatment approaches to be used concurrently. Sleep Hygiene Sleep hygiene is defined as the various practices put into place to support normal, quality nighttime sleep and full daytime alertness (National Sleep Foundation). It includes habits such as avoiding napping; decreasing or eliminating stimulants such as caffeine, nicotine, or alcohol; getting enough exercise; establishing a bedtime routine; and arranging the bedroom for optimal sleep (i.e., decreasing the temperature, eliminating unnecessary light, and removing technology devices). It can also include such practices as avoiding clock watching when in bed, exposing oneself to bright light or sunlight after waking, refraining from large meals before bedtime, and keeping a regular wake and bedtime schedule. While sleep hygiene can help the average person address general sleep difficulties, it alone is not sufficient to overpower the symptoms of major sleep disorders. With true sleep disorders, a combination of multiple treatment approaches earns the most effective results. Therapy Cognitive behavioral therapy, which looks at the relationships between the mind, body, emotions, behaviors, and illness, is the gold standard of therapeutic care for treatment of sleep disorders such as insomnia. This therapeutic approach helps clients to make behavioral changes to improve sleep hygiene, while also changing thought patterns to decrease the catastrophic thinking, anger, frustration, or hopelessness that is common for clients struggling with sleep disorders. Therapeutic tools like sleep journals, cognitive restructuring, guided imagery, and hypnosis can help clients gain objectivity about their sleep and grow out of the destructive narrative that leads to the anger and worry. Medication Medications such as sedative-hypnotics are commonly used to treat sleep disorders, though some research argues that they are not the most effective form of treatment. While they do increase an individual’s overall quantity of sleep, they do not always increase the quality of sleep. These medications can impact brain chemistry and often leave clients feeling groggy, foggy, unclear, and drained of energy, even after a full night’s sleep. They can also, over time, increase mortality risks. That being said, sedative-hypnotics may be helpful as a short-term treatment for sleep disorders, but therapeutic and holistic approaches to treatment are much more effective and safer. Holistic Approaches There are several holistic treatments that can help decrease or eliminate sleep disorders. For example, clients can learn to use self-hypnosis or meditation at bedtime, which can not only help decrease a client’s worry and anxiety, but also work to relax the sympathetic nervous system and increase the client’s probability of falling asleep. Similarly, activities like regular exercise, acupuncture, and massage can also have positively impact on a client’s body and mental state, decreasing symptoms of sleep disorders and resulting in greater sleep quality. MY APPROACH Sometimes, sleep disorders are the root issue for a client’s sleep difficulties. Oftentimes, however, sleep disorders are just a symptom of a bigger problem, be it a physical ailment or a psychological condition. For example, symptoms of PTSD, complex grief, or trauma can all manifest as insomnia. In these instances, treating the insomnia can help improve quality of sleep but will not necessarily treat the root issue. For this reason, sleep hygiene usually is not sufficient – the underlying issue has to be treated as well. I call myself a holistic behavioral medicine psychologist. I believe in the power of SSRIs like Celexa, or Effexor, or Lexapro, or Paxil, or Prozac, and know they can be very effective people with complex anxiety, depression, or insomnia. I also believe, however, that treatment needs to address more than just the symptom. It needs to get to the core issue, and I use therapeutic and holistic treatments for this. In my practice treating sleep disorders, I always incorporate at least two forms of treatment to help my clients. Integrating cognitive behavioral therapy techniques with more holistic forms of treatment allows the client and me to identify the root cause to provide more sustainable results by looking at several aspects of their well-being. My approach blends cognitive restructuring with things like hypnosis meditation to teach people how to overcome areas where they’ve gotten stuck, whether it is a sleep disorder or something more. Studies show that people can function on five and a half hours of sleep, which is considered the core physiology sleep. When people who suffer from sleep disorders get five and a half to six and a half hours and are prone to catastrophizing, it is important to reinforce to them that they are actually getting their core physiological restorative sleep, their stage 3 and 4 delta EEG wave sleep, which allows them to function sufficiently throughout the day. Acceptance and tolerance can also have a big impact on treatments for sleep disorders. When clients start catastrophizing, trying to find the ‘whys,’ or predicting the future, they are actually increasing their anxiety and increasing the activity in their sympathetic nervous system. At that point, I coach clients to let go of the need to know why. I help them redirect their efforts to focus on the solution, and direct them to stop doing research and searching the internet to learn more about the problem. When clients are prone irritability or susceptible to anxiety or depression, cognitive reframing can help them shift their perspective to tolerate sleep loss and have an above average day. Sleep mantras can be helpful in building acceptance. I like help people incorporate sleep mantras such as “Even though I haven’t slept well in the last 2-3 days, I now have more sleep inertia or sleep drive. And therefore it increases the likelihood that I’ll sleep well tonight or tomorrow night.” into their nightly habits. I guide my patients to say that they will sleep well tonight or tomorrow night so they don’t put a lot of pressure on themselves that they

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How to Help Insomnia: Focus on Solutions, Not Causes

Cognitive Behavioral Therapy (CBT), Insomnia, Sleep Psychology, Treatment for Sleep Disorders / admin

How to Help Insomnia: Focus on Solutions, Not Causes By Dr. Charles R. Freeman, Ph.D. How to help insomnia is one of the most common questions I hear from patients. Many people spend years searching for reasons they cannot sleep, hoping that understanding the cause will solve the problem. While insight can sometimes be helpful, learning how to help insomnia usually involves practical strategies that improve sleep, reduce anxiety, and restore healthy daily functioning. Every week I remind patients that “why” questions are often less important than “how” questions. Instead of spending months searching for every possible explanation, we focus on how to reduce symptoms, improve sleep, regain emotional balance, and restore quality of life. People usually seek therapy because they want relief from suffering, not because they want a detailed historical analysis of every factor that contributed to their current challenges. How to Help Insomnia by Looking Forward Many people assume that if they can identify the exact cause of their insomnia, everything will improve. Unfortunately, life is rarely that simple. A person may know that their sleep difficulties began after a divorce, a medical diagnosis, a traumatic event, financial stress, or a period of overwhelming responsibility. Understanding that history can provide valuable context, but it does not automatically eliminate sleep problems. The same principle applies to anxiety, depression, chronic pain, and post-traumatic stress disorder. Insight can be useful, but insight alone rarely changes behavior. Lasting improvement usually occurs when people learn practical skills that help them respond differently to thoughts, emotions, physical symptoms, and daily stressors. Many patients spend years trying to answer questions that have no clear answer. Even when answers exist, they often do not create meaningful change. Treatment becomes more productive when attention shifts from asking why symptoms developed to asking how symptoms can improve. How to Help Insomnia Using CBT One of the most effective approaches for treating insomnia sleep disorder symptoms is Cognitive Behavioral Therapy for Insomnia, often called CBT-I. Research consistently shows that CBT-I can help people improve sleep quality, reduce nighttime anxiety, and achieve long-term improvements in sleep without relying solely on medication. CBT helps people identify thoughts, habits, and behaviors that contribute to trouble sleeping. Many individuals with chronic insomnia develop patterns that unintentionally strengthen the problem. They may spend excessive time in bed, worry constantly about sleep, monitor the clock throughout the night, or develop fears about the consequences of poor sleep. CBT-I teaches practical skills that help break these patterns. Instead of fighting with sleep, patients learn strategies that strengthen the body’s natural sleep system and reduce the mental and emotional factors that contribute to insomnia. For many people, CBT-I becomes one of the most effective forms of sleeplessness treatment because it addresses both behavior and thinking patterns rather than simply masking symptoms. Sleep and Mental Health Sleep and mental health are closely connected. Anxiety, depression, trauma, and chronic stress frequently contribute to sleep difficulties. At the same time, lack of sleep can worsen emotional distress and make existing symptoms more difficult to manage. When people experience ongoing sleep problems, they often report increased irritability, reduced concentration, lower frustration tolerance, and greater emotional reactivity. Small challenges can begin to feel overwhelming when the brain is not receiving adequate restorative sleep. This relationship works in both directions. Poor sleep can contribute to anxiety and depression, while anxiety and depression can make it more difficult to sleep. Successful treatment often requires addressing both sleep and mental health at the same time. As sleep improves, many patients notice improvements in mood, energy, motivation, concentration, and overall well-being. How to Help Insomnia with Practical Solutions My approach to treatment focuses heavily on practical solutions. During the initial sessions, we spend some time understanding the history of symptoms and identifying important contributing factors. That information helps guide treatment, but it does not become the primary focus of therapy. Instead, we concentrate on helping people develop skills that produce measurable improvements in daily life. For some individuals, treatment may focus on improving sleep habits and reducing behaviors that interfere with healthy sleep. Others may benefit from stress-management techniques, emotional regulation skills, cognitive restructuring, or behavioral interventions that help decrease anxiety and improve coping. Many patients are surprised by how much progress they can make when they stop searching endlessly for explanations and begin focusing on actionable steps that support recovery. Beyond Traditional Talk Therapy Psychology has evolved considerably over the past several decades. Traditional insight-oriented approaches contributed important ideas to the field, but modern treatment increasingly emphasizes evidence-based methods that help people achieve meaningful results. Depending on the individual’s needs, treatment may include Cognitive Behavioral Therapy, Cognitive Behavioral Therapy for Insomnia (CBT-I), Eye Movement Desensitization and Reprocessing (EMDR), Emotional Freedom Techniques (EFT), Dialectical Behavior Therapy (DBT), clinical hypnosis, Positive Psychology, and other evidence-based interventions. These approaches focus on building skills, increasing resilience, changing unhelpful patterns, and helping individuals gain greater control over their thoughts, emotions, and behaviors. Lifestyle Factors Matter Many people underestimate the role that lifestyle plays in emotional health and sleep quality. Nutrition, exercise, stress management, social connection, and a sense of purpose can all influence mental and physical well-being. Healthy sleep habits support emotional resilience. Regular physical activity can reduce stress and improve sleep quality. Meaningful relationships provide support during difficult times. Activities that create a sense of purpose often strengthen psychological health and improve overall life satisfaction. When these factors improve, sleep often improves as well. How to Help Insomnia and Regain Control Whether you are struggling with insomnia, anxiety, depression, PTSD, chronic pain, or other challenges, the goal of treatment is not simply to understand what happened in the past. The goal is to develop practical tools that help you function more effectively in the present and create a healthier future. Understanding your story can be valuable. Learning how to change your daily experience is often far more powerful. If you are searching for how to help insomnia, the answer usually involves more than identifying causes. Effective treatment focuses on practical solutions, evidence-based strategies, healthier habits, and new ways of responding to stress and

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