As you can tell from the picture, when it comes to sleeping, puppy Watson is somewhat of an expert. If you ask Watson Chaudhry, the best way to get restorative sleep is by using a technique called cognitive behavioral therapy for insomnia or CBT-i.
What is CBT-i? Cognitive behavioral therapy for insomnia is a research proven, first-line treatment option for insomnia. In my integrative medicine practice as a physician, I have used CBT-i successfully with many patients who have improved not only duration but also quality of their sleep.
CBT-i is about reframing your thoughts and narrative around sleep.
So exactly how does CBT-i work and why is it so powerful?
We live in a wake centric world where energy drinks, efficiency, productivity, caffeine etc. are valued. So the first step in changing your sleep requires simply prioritizing sleep. My dog taught me this one! Watson can honestly sleep anywhere and anytime as evidenced in the picture.
Every sleep coach may have a slightly different version of CBT, but here are the components of the Watson Chaudhry CBT-i method. Stimulus control therapy: This is designed to strengthen the idea bed = sleep. Depending on the type of insomnia, there are several strategies that your sleep coach can recommend to achieve this.
Cognitive restructuring: This goes hand in hand with stimulus control in a yin-yang fashion. The core concept behind cognitive restructuring is to break the cycle that causes negative or dysfunctional thoughts around sleep. In other words, this strategy helps in improving one’s relationship with the sleep state.
Sleep restriction: Yes you heard it right. I know it sounds counter intuitive to restrict your sleep, but it truly works. Sleep restriction is done in a very formatted and graded manner. Sleep coaches will be able to walk you through how to do this safely.
Relaxation/mind-body techniques: There are several ways of incorporating this in your daily life. This doesn’t mean simply chanting “om.” A good sleep coach will personalize mind-body techniques and choose ones that are right for you.
Optimizing sleep hygiene/environment: This is a concept that really needs a lot of attention. Our wakeful state most certainly dictates the quality of our sleep. Everything from stress, physical movement, food we ingest, to our environment, can drive our sleeping habits. An in-depth analysis is required to get to the root cause of insomnia.
Circadian entrainment: Backed by science and huge body of research, we know that our internal bodily function works in a circadian rhythm and disregulation of this rhythm can lead to decreased sleep quality. The concept of entrainment is synchronization of the internal biological clock rhythm to external time cues. Whether it is use of light therapy or certain foods or supplements that can increase melatonin, or even grounding in the morning, as a sleep coach I consider out of the box therapies to help people reestablish harmony and balance.
Dream discussion/journaling: This last strategy is my absolute favorite. I truly believe in order to restore balance in sleep and wake state, exploration of dreams is invaluable. Word of caution, this strategy is not meant to over analyze the dream state but simply being mindful of the existence of the state itself.
Until next time, Shiven Chaudhry, MD