Posted: May. 30, 2013

CBT and Sleep Disorders

CBT and Sleep Disorders


Common Sleep Disorders



Dr. Giaquinto utilizes Cognitive-Behavioral Therapy (CBT) in treating the following sleep disorders: 


Primary Insomnia, which has three subdivisions.

  1. Early Insomnia:  Taking more than 20 minutes to fall asleep at the beginning of the night.
  2. Middle Insomnia:  Waking up in the middle of the night and having difficulty falling back to sleep (20 minutes or longer).
  3. Late Insomnia:  Waking up 2-3 hours earlier than usual and not being able to fall back asleep.

Circadian Rhythm Sleep Disorder, which is a persistent or recurrent pattern of sleep disruption leading to excessive sleepiness or insomnia that is due to a mismatch between one’s sleep-wake schedule.

Nightmare Disorder, which is repeated awakenings from sleep or naps with explicit recall of very frightening dreams.

Sleep Terror Disorder, which is recurrent episodes of abrupt awakening from sleep, usually occurring during the first third part of the major sleep episode and beginning with a panic-like scream. 

Dr. Giaquinto administers specific sleep assessment questionnaires along with a clinical interview to assess the sleep disorder.  The interview also uncovers any underlying issues that might relate or cause the sleep disorder (i.e., anxiety, fear, depression, ocd).   

Individual therapy sessions are then scheduled for a minimum of once per week (twice per week if needed) until sleep has been restored to a desirable state and any other underlying issues have been resolved.


Symptoms and Effects of Insomnia


                                   Nighttime                                                                                 Daytime


·  Difficulty falling asleep despite being tired                           ·  Daytime drowsiness, fatigue, or irritability

·  Relying on sleeping pills or alcohol to fall asleep               ·  Difficulty concentrating; poor job/school performance

·  Awakening frequently or lying awake in the                         ·  Lower reaction times and diminished mental alertness; increased likelihood of accidents   

    middle of the night                                                                           

·  Awakening too early in the morning and not                        ·  Weakened immune system 

    feeling refreshed                                                                       ·  Increased risk of depression, anxiety and substance abuse



Cognitive Behavioral Therapy and the Treatment of Sleep Disorders


While sleeping medication is big business, research has shown that the most effective treatment for insomnia is actually Cognitive Behavioral Therapy (CBT).


·  The most important aspect of CBT for insomnia is that it actually treats the cause of the insomnia itself – and not just the symptoms as medication does.  CBT can be combined with medication for patients who need rapid relief or to help initially break a pattern of insomnia. 

·  CBT is effective because the primary cause of insomnia is over–arousal or a “too active” awake system in the brain (not being able to “shut your mind off”).

·  Cognitive Behavioral techniques assist one in understanding the power of cognitive processes in our emotional states and general health.

·  CBT helps reduce worry, anxiety, depression, and fear that one won’t sleep by providing accurate information about sleep. 

·  Cognitive techniques help people identify, challenge and replace negative, inaccurate, distorted sleep thoughts with accurate, positive, rational sleep thoughts. 

·  Cognitive restructuring will involve challenging negative sleep thoughts at night and during the day with accurate information.

·  CBT often incorporates behavioral techniques as part of therapy (e.g., sleep scheduling and sleep restriction).

·  CBT teaches proper nighttime behavior that fosters healthy, restful sleep



Cognitive Behavioral Treatment of Insomnia Will Teach You:



  1. Sleep Hygiene
  1. Night time behaviors
  1. The 20 Minute Rule
  1. Relaxation Techniques
  1. Self – Hypnosis
  1. Sleep Efficiency
  1. Problem-Solving Skills
  1. Relationship between Thoughts, Feelings, and Behaviors
  1. Myths about Sleep (e.g., restorative, napping)
  1. Sleep Education


  • Nighttime rituals
  • Stimulus control
  • Tired vs. sleepy
  • Sleep schedules
  • Winding down

       11)How to Shut Your Mind Off



Sleep Disorder Quiz


If you answer yes to any of the following questions about sleep disorders, you may be dealing with insomnia or another type of sleep problem. Consult your doctor.


  1. Do you snore loudly and/or heavily while asleep??Yes or No
  2. Are you excessively sleepy or do you lack energy in the daytime??Yes or No?
  3. Do you have trouble with concentration or memory loss??Yes or No?
  4. Do you fall asleep while driving, in meetings, while reading a book, or while watching television??Yes or No?
  5. Do you have occasional morning headaches??Yes or No?
  6. Do you sleepwalk, have nightmares, or have night terrors??Yes or No?
  7. Do you suffer from depression or mood changes??Yes or No?
  8. Do you have trouble going to sleep or staying asleep??Yes or No?
  9. Have you experienced recent weight gain or high blood pressure??Yes or No?

Have you been told you hold your breath when you sleep??Yes or No



Please Contact Today For An Appointment: (818) 618-8830

Dr. Edward Giaquinto, Ph.D. - A licensed, clinical psychologist who has been assisting people in improving their life by increasing their emotional and mental health.