Sleep troubles keeping you up? Go from restless to rested –how therapy can help

May 30

Sleep disorders are more common – and treatable than you might think!

Ever felt alone with your sleep troubles? Many people experience sleep issues from time to time. In fact, sleep issues are more common than you might think. More than one-third of the United States (US) population gets less than ideal sleep, and between 50 and 70 million US adults have various sleep disorders (Baranwal, Yu, & Siegel, 2023). Research shows that about 10% of the population experience chronic insomnia, where sleep problems persist for months or even years (Soyka et al., 2023). Additionally, up to 70% of people with mental health disorders experience sleep difficulties, and 30% meet criteria for insomnia (Hertenstein et al., 2022).

Why Quality Sleep Matters

Sleep isn’t just “rest”—it’s essential for emotional regulation, memory consolidation, immune function, and overall brain health. When we don’t sleep well, everything feels harder: our patience wears thin, our thinking gets foggy, and our mood takes a hit. Chronic sleep problems can increase the risk of depression, anxiety, cardiovascular issues, and even memory problems later in life.

That’s why addressing sleep concerns isn’t a luxury—it’s a vital part of your mental and physical health.

CBT-I: A proven, lasting solution

Cognitive therapy for insomnia (CBT-I) is considered the gold-standard treatment for chronic insomnia, offering long-term improvement without medication, and with zero side effects. CBT-I is a structured, evidence-based approach that targets the thoughts, habits, and behaviors that interfere with sleep. Research consistently shows that CBT-I is as effective as medication in the short term and more effective in the long term, with no side effects and no risk of dependence.

CBT-I helps people:

· Understand how anxiety and overthinking affect sleep

· Create healthier bedtime routines and behaviors

· Break the cycle of “trying too hard” to sleep

· Rebuild confidence in their ability to sleep naturally

The skills learned in CBT-I are practical, personalized, and long-lasting.

The pitfalls of long-term medication for sleep

Despite the evidence and safety of CBT-I, medications are often prescribed for sleep issues. These medications can be helpful in the short term, but they often come with risks and limitations, including drug tolerance, dependence, and a lack of evidence supporting their long-term effectiveness (Soyka et al., 2023). In particular, long-term use of benzodiazepines has been linked to memory issues, increased anxiety, and disrupted sleep cycles (Ritvo et al., 2023).

Don’t let these statistics overwhelm you – medication can offer the benefit of short-term sleep support and with the right tools and guidance, it’s possible to transition to healthier, more sustainable sleep habits over time.

Whether it’s through therapy, education, or simple behavior shifts, taking small steps toward better sleep hygiene can have a big impact.

If you’re ready to improve your sleep, there’s support available. Start by exploring trusted resources:

· Try a reputable book or podcast on sleep psychology

· Watch an educational video on sleep hygiene or CBT-I

· Experiment with small, low-pressure changes to your evening routine

· Check out the evidence-based tips below to start building healthier habits

And remember: you’re not failing if you need support. Sleep is a complex, deeply personal issue—and there are tools, strategies, and professionals who can help.

Here are some ideas for how to establish a good sleep routine

1. Start thinking about sleep 2-3 hours before bedtime. Lower the lights, disengage from anything very stimulating (loud & fast music, video games & social media, screens in general)

2. Find a calming routine for your evening. Examples are reading a book, taking a bath, listen to relaxing music, or journaling about your day

3. Turn off all screens at least one hour before bedtime (the light & activities are highly stimulating and can even trick you into feeling awake/alert when you are tired)

4. You should see your bed as a restful place, for sleeping and sex. Avoid watching TV or scrolling on your phone in bed – set up a phone charging station across the room or better yet in another room altogether.

OK I’m in bed, and I can’t sleep – now what?

It’s important to let go of the pressure you feel to get to sleep. I get it – of course we all want a good night’s rest, however by holding onto these worries about how much sleep we are getting and why we aren’t getting enough, we can inadvertently create more anxiety for ourselves. The trick is to let go of expectations altogether. Just think “let it go.”

1. Tell yourself it’s ok if you don’t sleep occasionally. Take the pressure off to have an ideal sleep schedule right away. Tell yourself “it’s ok, my body will rest when it is ready. I’m going to relax peacefully.”

2. If you are still awake after 20-30 minutes, you can get up and quietly do an activity like reading something mildly interesting (no thrillers please!) Use a warm-toned book light or other small lamp.

3. Get back into bed when you feel sleepy, repeat the above to yourself. Aim to remove the pressure to sleep – your job is just to create a calm environment to rest. Any thought that get in the way, just “let it go.”

What else can help me sleep better?

Sometimes, small environmental shifts can make a big difference when it comes to winding down. Here are a few gentle questions to ask yourself as you think about your sleep setup:

Is your space calm, dark, and quiet?
A cooler temperature, blackout curtains, white noise, or earplugs can create a more restful atmosphere and help signal to your body that it’s time for sleep.
Where do you put your phone at night?
If it’s glowing nearby or you find yourself scrolling out of habit (and who doesn’t these days), consider placing it on night mode—or better yet, across the room. Giving your brain a break from screens can support deeper rest.
Is your bed truly comfortable for you?
Whether it’s adjusting the number of pillows, choosing cooler sheets, or exploring a new mattress, small tweaks to your bed can have a surprisingly big impact.

A Mental Health Approach to Sleep: Be Gentle With Yourself

One of the most powerful shifts you can make around sleep isn’t about what you do—it’s about how you relate to your experience of not sleeping.

So often, we put pressure on ourselves to fall asleep by a certain time, or we start mentally calculating how much sleep we’re losing:
“Okay, if I fall asleep now, I’ll get 6.5 hours… now it’s only 6…”
This kind of internal countdown can actually increase anxiety and make sleep feel even more out of reach.

What helps instead is a mindset of acceptance and self-compassion. You might try gently reminding yourself:

“It’s okay if I’m not sleeping right now. My job is simply to rest. Sleep will come when it comes.”

By taking the pressure off, you allow your body and mind to relax into a state that’s much more welcoming to sleep. And even if sleep takes time, resting calmly is still healing. This simple mental shift can bring down nighttime stress and help rewire your relationship with sleep over time.

Don’t forget your morning routine!

Make sure to get up in the morning at the normal time, even if you didn’t sleep as long as you wanted to. Research shows that getting up at the same time every morning will help reset your mental clock and help with feeling sleepy at bedtime too. Also, as tempting as a nap can be, if you are sleeping more than 45 minutes, that sleep could be interfering with your nighttime sleep – so avoid until you have a solid sleep routine that works for you! In the morning, getting outside to see the sunlight helps as well. Even a 10-15 minute walk can do wonders – I specifically don’t wear my sunglasses on this walk so that my eyes really take in the sunlight and send those signals to the brain that it is daytime.

Contact us to book a consultation about sleep support and/or therapy for better sleep.

If this article helped you, like & share it with a friend!

Please note: This article is for informational purposes only and isn’t a substitute for personalized medical advice. Everyone’s situation is unique—if you’re struggling with sleep or mental health, it’s best to consult with a qualified healthcare provider.

Citations:

Baranwal, N., Phoebe, K. Y., & Siegel, N. S. (2023). Sleep physiology, pathophysiology, and sleep hygiene. Progress in cardiovascular diseases, 77, 59-69.

Hertenstein, E., Trinca, E., Wunderlin, M., Schneider, C. L., Züst, M. A., Fehér, K. D., ... & Nissen, C. (2022). Cognitive behavioral therapy for insomnia in patients with mental disorders and comorbid insomnia: A systematic review and meta-analysis. Sleep medicine reviews, 62, 101597.

Ritvo AD, Foster DE, Huff C, Finlayson AJR, Silvernail B, Martin PR (2023) Long-term consequences of benzodiazepine-induced neurological dysfunction: A survey. PLoS ONE 18(6): e0285584. https://doi.org/10.1371/journal.pone.0285584

Soyka, M., Wild, I., Caulet, B., Leontiou, C., Lugoboni, F., & Hajak, G. (2023). Long-term use of benzodiazepines in chronic insomnia: a European perspective. Frontiers in psychiatry, 14, 1212028.

Heidi Cox, Ph.D.