CBT for insomnia, Bristol



Sleep therapy is based on Cognitive Behavioural Therapy for insomnia (CBT-i), a form of cognitive behavioural therapy specifically focused towards sleep problems and insomnia. It is based on a model that proposes sleep problems may be triggered by a stressful event (although not always) but the problem continues after the event passes due to an individual forming certain attitudes/ beliefs and behaviours and associated emotions that interfere with sleep. The idea behind CBT-i is to change these thoughts, behaviours and emotions to restore better quality sleep.

Cognitive behavioural therapy for insomnia (CBT for Insomnia or CBT-i) has been shown in numerous clinical trials to help overcome insomnia in the long term, whereas evidence indicates the effects of sleeping pills are mostly short-term. Because of this, advisory bodies such as the National Institute of Clinical Excellence (NICE) recommend CBT for insomnia (CBT-i) as the preferred treatment for persistent sleep problems. Scientific studies using clinical trails show that on average 70% of people with even long-term sleep problems obtain lasting benefit from the treatment. This is backed up by my own personal experience of working with people with insomnia.

Cognitive techniques address the mental factors that contribute to insomnia such as erroneous beliefs about sleep, a racing mind and worrying thoughts about sleep. Behavioural therapy aims to re-establish lost connections between the bed and good sleep and to help individuals with sleep problems to establish a healthy sleep routine. In this way sleep becomes a more automatic process and a more reliable sleep pattern is established. I teach these techniques to individuals so they can use them at home to help themselves improve their sleep.

I also use a technique called motivational interviewing which focuses on the motivational processes within an individual that bring about change. This technique aims to explore and resolve ambivalence to change in order to elicit and strengthen motivation for change. In this way change is not imposed but supported in a manner consistent with the individual’s values.

The first step is to have a detailed, 75-minute sleep assessment to understand the nature of the problem and to see if sleep therapy would be suitable. Following the assessment and if my treatment is suitable, I typically run a structured 5-7 week program, with weekly or fortnightly sessions lasting 55-60 minutes. All appointment are £80, including the initial assessment. Treatment includes the following components:

  • Psycho-education about sleep and insomnia
  • Sleep hygiene
  • Sleep restructuring, based on a sleep diary
  • Stimulus control (building a strong association between the bed and sleep)
  • Goal setting and behaviour change
  • Identifying unhelpful thinking and thought challenging
  • Relaxation techniques
  • Relapse prevention and maintaining healthy sleep habits

I run face to face, online or telephone sessions. My face to face appointments are at the Bristol Natural Health Service, 407 Gloucester Rd, Bristol, BS7 8TS.

“I have so appreciated your genuine concern and interest in helping me to work through the problem with sound advice, explanatory notes and meaningful homework. You have listened, and given support and encouragement throughout the course and you have explained the process and helped me though difficult times. I feel that the CBT is now taking effect and that I have the knowledge and impetus to move slowly forward.”

“Without doubt I am certainly sleeping vastly better than when I came to you, I am not nearly so worried about it and feel much more in control, thanks to you.”