Adults and Sleep: How CBT-I Can Help Most of us have experienced restless nights — lying awake with a busy mind, clock-watching, or waking too early and unable to get back to sleep. For some, these nights turn into weeks or months of disrupted rest. Over time, insomnia affects not only mood and concentration but also physical health and overall quality of life. In Australia, clinical guidelines from the Royal Australian College of General Practitioners (RACGP) and the Australian Psychological Society (APS) recommend Cognitive Behavioural Therapy for Insomnia (CBT-I) as the first-line treatment for persistent sleep difficulties. Unlike medication, CBT-I addresses the root causes of insomnia and teaches practical skills for long-term sleep improvement. Why Sleep Matters According to the RANZCP Clinical Practice Guidelines for Mood Disorders (2020), poor sleep is both a symptom and a risk factor for a wide range of mental health conditions, including depression and anxiety. Adequate, good-quality sleep helps: Regulate mood and reduce emotional reactivity Strengthen the immune system and lower risk of chronic illness Improve memory, concentration, and learning Maintain healthy energy levels and motivation Common Sleep Struggles in Adults Adults often describe similar problems: Racing thoughts at bedtime about work, family, or health Middle-of-the-night waking and lying awake for hours Reliance on “sleep crutches” such as alcohol, caffeine, or late-night screens Anxiety about sleep itself, creating a cycle of worry and wakefulness National and international guidelines (RACGP, NICE, APS) highlight that unhelpful coping behaviours — like staying in bed awake, or clock-watching — often worsen insomnia over time. How CBT-I Works CBT-I is strongly recommended in the RACGP Guideline for the Management of Insomnia in Adults (2019), the APS Evidence-Based Psychological Interventions Guide (2018 update), and the NICE Guidelines (UK, 2021). Research shows CBT-I is effective for both short-term and chronic insomnia, often more effective than medication (Trauer et al., 2015). CBT-I involves: 1. Establishing a Consistent Sleep Routine Go to bed and wake up at the same time every day, including weekends. Consistency stabilises the circadian rhythm, as endorsed by APS and RACGP recommendations. 2. Stimulus Control Only use the bed for sleep and intimacy. If awake for more than ~20 minutes, get up and do something calming until sleepy. This retrains the brain to associate bed with sleep rather than frustration. 3. Sleep Restriction Therapy Initially, limit time in bed to match actual sleep time. Once sleep becomes deeper and more consolidated, time in bed is gradually increased. Both RACGP and APS guidelines support this as one of the most effective interventions. 4. Challenging Unhelpful Thoughts Many people with insomnia believe things like, “If I don’t sleep eight hours, tomorrow will be ruined.” CBT-I helps reframe these beliefs, reducing sleep-related anxiety. 5. Relaxation and Wind-Down Routines Evidence-based strategies such as progressive muscle relaxation, mindfulness, and breathing exercises can lower arousal and prepare the body for rest. What Not to Do National guidelines consistently caution against: Using alcohol, nicotine, or caffeine close to bedtime Relying solely on sleep medication for long-term management Punishing yourself for a poor night — instead, focus on building consistent habits When to Seek Support According to the APS guidelines, if insomnia persists for more than 3 nights a week over at least 3 months, professional help should be sought. A psychologist trained in CBT-I can tailor strategies to your situation and provide ongoing support.

 

Our mission is to help reduce the stigma of seeking help and to help people build their resilience.

Adults and Sleep: How CBT-I Can Help

 

Most of us have experienced restless nights lying awake with a busy mind, clock-watching, or waking too early and unable to get back to sleep. For some, these nights turn into weeks or months of disrupted rest.

 

Over time, insomnia affects not only mood and concentration but also physical health and overall quality of life.

 

In Australia, clinical guidelines recommend Cognitive Behavioural Therapy for Insomnia (CBT-I) as the first-line treatment for persistent sleep difficulties.

 

Unlike medication, CBT-I addresses the root causes of insomnia and teaches practical skills for long-term sleep improvement.

 

Why Sleep Matters: According to the RANZCP Clinical Practice Guidelines for Mood Disorders (2020), poor sleep is both a symptom and a risk factor for a wide range of mental health conditions, including depression and anxiety.

 

Adequate, good-quality sleep helps: Regulate mood and reduce emotional reactivity Strengthen the immune system and lower risk of chronic illness Improve memory, concentration, and learning Maintain healthy energy levels and motivation

 

Common Sleep Struggles in Adults: Racing thoughts at bedtime about work, family, or health Middle-of-the-night waking and lying awake for hours Reliance on “sleep crutches” such as alcohol, caffeine, or late-night screens Anxiety about sleep itself, creating a cycle of worry and wakefulness National and international guidelines (RACGP, NICE, APS) highlight that unhelpful coping behaviours like staying in bed awake, or clock-watching often worsen insomnia over time.

 

How CBT-I Works CBT-I is strongly recommended in the RACGP Guideline for the Management of Insomnia in Adults (2019), the APS Evidence-Based Psychological Interventions Guide (2018 update), and the NICE Guidelines (UK, 2021). Research shows CBT-I is effective for both short-term and chronic insomnia, often more effective than medication (Trauer et al., 2015).

 

CBT-I involves:

1. Establishing a Consistent Sleep Routine Go to bed and wake up at the same time every day, including weekends. Consistency stabilises the circadian rhythm, as endorsed by APS and RACGP recommendations.

 

2. Stimulus Control Only use the bed for sleep and intimacy. If awake for more than 20 minutes, get up and do something calming until sleepy. This retrains the brain to associate bed with sleep rather than frustration.

 

3. Sleep Restriction Therapy, limit time in bed to match actual sleep time.

 

4. Challenging Unhelpful Thoughts Many people with insomnia believe things like, “If I don’t sleep eight hours, tomorrow will be ruined.” CBT-I helps reframe these beliefs, reducing sleep-related anxiety.

 

5. Relaxation and Wind-Down Routines Evidence-based strategies such as progressive muscle relaxation, mindfulness, and breathing exercises can lower arousal and prepare the body for rest.

 

What Not to Do 


National guidelines consistently caution against:

·      Using alcohol, nicotine, or caffeine close to bedtime

·      Relying solely on sleep medication for long-term management

·      Punishing yourself for a poor night instead, focus on building consistent habits

 

 When to Seek Support 


According to the APS guidelines, if insomnia persists for more than 3 nights a week over at least 3 months, professional help should be sought.

 

·      A psychologist trained in CBT-I can tailor strategies to your situation and provide ongoing support.

 

·      With a structured, evidence-based plan, you can regain restful sleep and improve your wellbeing.

 

·      CBT-I is the most effective first-line treatment for adults with persistent insomnia.

 

References


Australian Psychological Society. (2018). Evidence-based psychological interventions in the treatment of mental disorders: Fourth edition. APS.


 Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis. Annals of Internal Medicine, 163(3), 191–204. https://doi.org/10.7326/M14-2841

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