CBT-I is quicly becoming the most prescribed treatment for insomnia. It helps us to identify thoughts, feelings, and behaviors that are contributing to the symptoms of insomnia.

CBTi exploration includes cognitive, behavioral, and educational components. (You have already completed the educational portion in lesson 1 of this module.)

Cognitive interventions: Cognitive restructuring attempts to change inaccurate or unhelpful thoughts about sleep.
Behavioral interventions: Stimulus control before bed, sleep restriction and compression, and incorporating relaxation techniques help to establish healthy pre-sleep habits.
Sleep education: Providing information about the connection between thoughts, feelings, behaviors, and sleep is central to CBT-I.

In this lesson we begin by exploring our thoughts and feelings that hinder sleep and those that help to offer safety to the nervous system and brain.

With both pain and insomnia, inaccurate or dysfunctional thoughts about sleep (and pain) may lead to behaviors that make sleep more difficult, which then reinforce the dysfunctional thoughts. For example, months or years of insomnia may lead to worry about falling asleep and spending excessive time in bed to try to force sleep. This can make falling asleep more challenging and create a frustrating, nightly cycle that is difficult to break.

Thinking or cognitive restructuring begins to break this cycle by identifying, challenging, and altering the thoughts and beliefs that contribute to insomnia.

Common thoughts and beliefs based on repeated exposure to dysfunctional sleep are anxiousness about falling asleep and daytime fatigue, as well as unrealistic expectations of sleep time and quality ( I know I should be getting 8 hours of sleep but I never seem to get that).

Action Step #1:

Complete this quiz on 'Sleep Beliefs Questionnaire' first. This is found in the resource section below.

Action Step # 2:

In chapter 10 of your academy workbook you will find your worksheets to help you identify and reframe your sleep thoughts. Just like the work we did in restructuring your negative bias in module 2, this exercise is much the same.

Time to tune in and listen to the thoughts that you are hearing inside your internal dialogue. On your worksheet, brainstorm as many thoughts you are having about sleep. Some of these thoughts might include, 'I'm afraid to go to sleep', or 'I know it's going to take me forever to fall asleep', or finally, 'I've got to get 8 hours of sleep or tomorrow is going to be awful.' (You can also get inspiration from the Sleep Beliefs Questionnaire).

When brainstorming, try not to overthink this process. Instead, allow the thoughts to come forward without judgement or without analyzing whether they are right or wrong. Write them all down on your worksheet. Then you can complete the rest of the chart with the pain or sleep voice, is it harmful or helpful, is it truth or is it a trap and finally, what your curious or sleepy brain would say.

If you are having difficulties brainstorming ideas or if you have any questions you can reach out to me via Voxer or by email to deana@pain2possibilities.com. Or you can always ask inside our Cwtch community.

Sleep Belief Restructuring

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