Kevyn A Monier, MSW, LMSW, CBT-C, EMDR-TR
Insomnia Therapy
Finding Rest: Treating Insomnia and Sleep-Wake Issues
“A good laugh and a long sleep are the two best cures for anything.” – Irish Proverb
Struggling to sleep isn’t just frustrating—it affects everything. When your nights are restless, your days can feel foggy, heavy, and out of sync. Whether you’re lying awake at 3 a.m. or waking up feeling like you never really rested, insomnia can leave you feeling drained, anxious, and stuck in a cycle that’s hard to break.
The good news? There’s help—and hope. Your body knows how to sleep. Sometimes, it just needs a little help remembering.
Understanding Insomnia
Insomnia is defined as difficulty falling asleep, staying asleep, or waking up too early—despite having the opportunity to sleep. It becomes a disorder when it starts interfering with your ability to function during the day.
Symptoms may include:
• Trouble falling or staying asleep
• Waking up feeling unrefreshed
• Excessive worrying about sleep
• Daytime fatigue or irritability
• Difficulty concentrating or functioning
Circadian Rhythm & the Two-Process Model of Sleep
Sleep is regulated by two core systems:
1. Sleep Drive (Process S): The longer you’re awake, the more your body builds up the need for sleep. Think of it like a pressure valve—it naturally builds until your body needs rest.
2. Circadian Rhythm (Process C): This is your internal clock, influenced by light, hormones, and behaviors. It regulates the timing of sleep and wakefulness, ideally aligning with the natural day-night cycle.
When these two systems fall out of sync, sleep struggles begin. You may feel sleepy at the wrong times or wide awake when you’re supposed to be resting. Modern life—screens, irregular schedules, stress—often throws this balance off, resulting in circadian rhythm sleep-wake disorders.
Types of Circadian Rhythm Disorders
Circadian Sleep-Wake Disorder
Occurs when your internal clock is misaligned with your desired or required sleep schedule.
Advanced Sleep Phase Disorder
You fall asleep much earlier than desired (e.g., 7–8 p.m.) and wake very early (e.g., 3–4 a.m.), often resulting in social or occupational disruptions.
Insomnia by the Numbers
• About 1 in 3 adults experience occasional insomnia
• Nearly 10% of U.S. adults suffer from chronic insomnia
• Insomnia is more common in women, older adults, and people with mental health conditions
• Many turn to over-the-counter sleep aids, but studies show they are less effective and can cause dependence or grogginess
Why CBT-I Works (and Medications Often Don’t)
Cognitive Behavioral Therapy for Insomnia (CBT-I) is considered the gold standard treatment for chronic insomnia. Unlike sleep medications, which only manage symptoms short-term, CBT-I addresses the root causes of insomnia and teaches lasting tools for healthy sleep.
CBT-I includes:
• Sleep scheduling and restriction (resetting your sleep drive)
• Stimulus control (retraining your brain to associate bed with sleep)
• Relaxation techniques (reducing nighttime arousal)
• Cognitive strategies (challenging unhelpful thoughts about sleep)
CBT-I is clinically proven to be more effective than sleeping pills or over-the-counter options, with longer-lasting results and no side effects.
Epworth Sleepiness Scale
How likely are you to doze off or fall asleep in the following situations (0 = would never doze, 3 = high chance of dozing)?
Situation (Score each one separately then add up your score)
-
Sitting and reading
-
Watching TV
-
Sitting inactive in a public place (e.g., theater or meeting)
-
As a passenger in a car for an hour without a break
-
Lying down to rest in the afternoon
-
Sitting and talking to someone
-
Sitting quietly after lunch (no alcohol)
-
In a car, while stopped for a few minutes in traffic
Total Score: ___ / 24
• 0–7: Unlikely to be abnormally sleepy
• 8–9: Average daytime sleepiness
• 10–15: Excessive sleepiness – may need medical attention
• 16–24: Severe sleepiness – consult a sleep specialist
Let's get you sleeping again!
