cognitive behavior therapy – watercress words by Dr Aletha

updated March 7, 2025

If you live somewhere that observes Daylight Saving Time, you may notice a disruption in your sleep for a few days after we “spring forward” in March and when we “fall back” to standard time in November.

Like jet lag from travel, these time changes can interrupt our sleep schedule for a few days. And if you already have trouble sleeping, it’s even more of a problem.

Here’s a review of what sleep professionals recommend to help. But for persistent or severe problems, see your own doctor to get started.

This information is current as of the date of original publication or update. It may have changed by the time you read this. I invite you to fact-check what you read here.

This information is not intended for diagnosis or treatment. Before making health decisions, discuss with your physician or other qualified healthcare provider to decide what is right for you.

This content is for your “information and inspiration”, and does not imply my endorsement or recommendation.

person sleeping on a couch — Sometimes getting a good night’s sleep can be a challenge.

(Affiliate links are used in this post. You don’t pay more to shop through these links; this blog may earn a small commission, which funds its existence. )

What is Chronic Insomnia?

Most of us have trouble sleeping occasionally, but if you persistently have difficulty with sleep, you may have a medical condition associated with sleep disturbances. These include

sleep apnea
restless legs syndrome
depression and/or anxiety
post-traumatic stress disorder

Some people have true chronic insomnia, meaning persistent sleep difficulty not due to some other cause. There are various criteria to diagnose chronic insomnia but in general include

difficulty falling or staying asleep
at least 3 nights per week for at least 1-3 months
with impairment of daytime function, such as fatigue/sleepiness, poor concentration, irritability, school or work dysfunction

How can you sleep better with chronic insomnia?

The first step for chronic or occasional insomnia is to identify and treat any underlying medical issues that cause poor sleep. In addition to the ones mentioned above these include

painful conditions
heartburn (gastroesophageal reflux)
congestive heart failure
lung diseases like asthma cause nighttime breathing difficulty
menopausal night sweats

Sleep specialists recommend non-drug management of chronic insomnia and reserve sleep medications for more resistant cases.

Sleep meds were one of the 7 drugs that are overused in my previous post.

a bed with ornate headboard — photo by Dr. Aletha- at the Hemingway house, Key West, Florida

(Read more about Ernest Hemingway’s preserved Florida home at this post)

Hemingway’s study- chaos and creativity

Behaviors for better sleep

Experts recommend sleep hygiene , basically lifestyle changes, as the initial treatment. Some people have developed bad habits in regards to sleep that need to be unlearned and new behaviors put in place.

For optimal sleep, you should

Engage in regular exercise- moderate intensity , tai chi , yoga and low-impact aerobic exercise
Avoid evening large meals
Limit caffeine, tobacco, and alcohol
Use the bedroom only to sleep and for sex
Maintain a regular bedtime-awake schedule
Avoid daytime naps
Avoid distracting stimuli at bedtime-watching television, using electronic devices, talking on the phone
Stay in bed only while sleep

Dim the lights for better sleep

The light from electronic devices- clocks, thermostats, televisions, monitors-can disturb your sleep even after you turn off your phone and tablets. This light can be blocked by stick on light blocking covers than can block out the majority of it.

Light from my clock made it hard for me to fall asleep before I discovered these products. With them I fall asleep easier, and can fall back asleep if I wake up.

Maintaining a regular schedule helps to set or reset your sleep/wake cycle. So go to bed at the same time every night and wake up at the same time every morning.

However, if you can’t sleep, rather than lie in bed awake, you should get up, do a non-stimulating activity, then return to bed when sleepy.

woman typing on a laptop keyboard. — Using a computer, laptop, or tablet before going to bed can impair sleep.

If you have persistent sleep loss, consider more intensive therapy by a professional.

Cognitive behavior therapy for insomnia , CBT-I, significantly improves chronic insomnia and daytime functioning and is recommended as first-line therapy.

Available on Audible on Amazon, 30 day free trial (affiliate link)

CBT-I combines cognitive therapy with sleep restriction, relaxation training, and stimulus control.

Treatment typically requires 5-8 sessions conducted by a health professional trained in its use. Patients need to participate by keeping a sleep diary and writing down daily thoughts in a journal while continuing with the sleep hygiene practices mentioned above.

person writing in a spiral notebook — Writing thoughts in a journal is often encouraged in cognitive behavioral therapy. (photo from the Lightstock.com collection)

SleepPhones

Natural Sleep Aid Created By A Doctor. A family physician created SleepPhones to help patients fall asleep faster and stay asleep longer without resorting to drugs.(affiliate link)

SleepPhone

Manage stress, learn to relax

If you have occasional trouble sleeping due to stress, relaxation techniques can help you. Techniques include meditation, yoga, imagery, abdominal breathing and muscle relaxation techniques. These can reduce tension and anxious thoughts that inhibit sleep onset and maintenance.

exploring the HEART of healthy sleep

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