Woman sleeps peacefully with head resting on pillow.Sleep plays a large role in the healthy functioning of the mind and body. Therapists or other mental health professionals can offer support for people with sleep/wake disorders. They may share coping solutions for long-term sleep issues. In therapy, people may learn skills for improving their sleep hygiene.

Therapists can also address the mental health aspect of sleep disorders. They may help people manage mental health related impacts of sleep issues.

Addressing Sleep Disturbances in Therapy

Some sleep disorders come from a medical condition. Others have psychological roots. A person might have some trouble sleeping during a difficult life transition. Anxiety or depression can also cause sleep issues. Without treatment, both conditions may worsen. There are numerous causes for sleep disturbances. Therapy is an often helpful solution. It may allow people to work through the cause and effects of sleep issues, depending on whether the cause is known.

Therapy for sleep-wake disorders generally focuses on:

  • Changing behaviors
  • Setting and achieving goals
  • Becoming more self-aware
  • Learning relaxation skills

Mental health professionals may help uncover the root cause of a sleep disorder. Therapists may then support people in developing skills to change unwanted sleep patterns.

Types of Therapy for Sleep Issues

Methods used in therapy to address sleep-wake disorders include:

  • Keeping a sleep diary. Doing so can help identify harmful sleep patterns. It may pinpoint triggers of disturbed sleep.
  • Sleep restriction therapy. This treatment may be especially effective for insomnia. It restricts naps and early bedtimes. This may help the person in treatment fall asleep at the right time and get quality sleep.
  • Stimulus control instructions. This method examines a person’s sleep habits. It aims to uncover actions that are preventing good sleep.
  • Sleep hygiene education. This is often used after sleeping patterns are analyzed. It is a form of training. People in treatment develop a list of things they should and should not do before bed. The list is tailored to their personal needs.
  • Relapse prevention. Sleep conditions may recur in the future. Relapse prevention seeks to help those in treatment prepare for the potential of future sleep trouble. It helps people develop methods to address concerns before they become overwhelming. 
  • Phototherapy. Timed light exposure can help reset internal body clocks. It is used to treat non-24 hour sleep/wake disorder. 
  • Dark therapy. Restricting light in the evening can help prevent delays to the circadian clock. This is especially true for blue-green light from screens. Limiting exposure to this light before bed may help people get to sleep earlier. This therapy is often combined with light therapy. That is, exposure to bright light when one first wakes up.
  • Cognitive behavioral therapy (CBT). A certain type of CBT may help treat insomnia. It is called CBT-I. This form of CBT attempts to change sleep habits and sleep schedule. It works on resolving misconceptions that may cause difficulty sleeping. Keeping a sleep diary is often a large part of the process.

Mental health issues may cause sleep problems. For example, PTSD may cause nightmares or insomnia. If a sleep disturbance is caused by a mental health issue, treating the underlying condition in therapy can help resolve it.

Tips for Better Sleep Hygiene

Improving sleep hygiene may help lessen the impact of sleep disorders. This may also reduce the effects of mental health issues caused by sleep issues. Below are some sleep hygiene tips. 

  • Get regular exercise, early in the day if possible.
  • Keep your bedroom dark and cool at night.
  • Avoid naps.
  • Turn off screens 1 hour before bedtime.
  • Avoid or limit alcohol and caffeine.
  • Keep a consistent sleep/wake schedule.
  • Meditate.
  • Practice breathing exercises.
  • Take a warm bath or shower before bed.
  • Avoid spending time on your bed throughout the day.

Sleep habits can vary from person to person. What promotes healthy sleep for one person may not work for someone else. It is important to pay attention to which tips work for you. A therapist may help you discover which sleep hygiene tips are helpful to you.

Therapy for Sleep Disorders: Case Example

Therapy to address effects of loss of sleep. Rico, 28, decides to seek therapy. He has had several months of diminished function. Rico tells the therapist he has had trouble sleeping ever since he changed jobs. His new schedule is less demanding. He does not understand why he is so tired. He has difficulty falling asleep. He also wakes up at odd intervals and lies awake for hours. Sometimes he naps to catch up on the sleep he has missed. But this makes it harder for him to sleep at night. Due to lost sleep, he is irritable during the day. He experiences anxiety and fatigue as night approaches. Assuming and believing that he “will never get to sleep” also takes a toll. He believes this dread is contributing to his wakefulness. In therapy, he explores his current feelings. Rico is ambivalent about the career change he recently made and anxious regarding the path his life has taken. He is worried about his so-far unfulfilled goals. Rico realizes in therapy that he has placed some aspects of life over others he cares more about. With the encouragement and support of the therapist, he identifies several aspects of his life that are important to him. He decides to, at least temporarily, focus on those things. Rico becomes more content with his choices and path. He finds himself able to achieve relaxation more easily and sleep without great disturbance. His daily function improves. Before long, his irritability diminishes.

References:

  1. An overview of sleep disorders. (n.d.). Retrieved from http://healthysleep.med.harvard.edu/healthy/getting/treatment/an-overview-of-sleep-disorders 
  2. Cognitive behavioral therapy for insomnia. (n.d.). Retrieved from https://sleepfoundation.org/sleep-news/cognitive-behavioral-therapy-insomnia
  3. Lubit, R. (2015, January 28). Sleep disorders treatment & management. Retrieved from http://emedicine.medscape.com/article/287104-treatment 
  4. Non-24-hour sleep wake disorder treatment & care. (n.d.). Retrieved from https://sleepfoundation.org/sleep-disorders-problems/non-24/treatment-care 
  5. Treatments for delayed sleep phase and non-24. (2015, October 19). Retrieved from http://www.circadiansleepdisorders.org/treatments.php