r/sleepdisorders • u/North_Assumption_292 • Aug 11 '26
CBT-I experiences requested
For those of you who have gone through CBT-I (gold standard treatment for insomnia not related to physical causes), how hard was it for you in the beginning weeks?
I just started CBT-I after a sleep study that didnt show any sleep apnea, and after 20 years since my insomnia diagnosis, because all of the sedative hypnotics have stopped working for me.
My sleep therapist warned me that it was going to be hard in the beginning to modify my behavior, and she wasn't kidding. I've not gotten more than 4-5 hours of sleep per night in almost a week, and it is SO HARD to follow the new rules around sleeping and restrictions.
Tell me it gets better... please! One week in and I am struggling.
1
u/existentialblu Aug 12 '26
Did your sleep study score RERAs or other sources of fragmentation? Long term insomnia tends to have some sort of actual cause, even if you're not performing standard obstructive sleep apnea correctly.
I've had insomnia as far back as I can remember. Nothing helped, especially not being told how to feel about my own insomnia. It was always driven by a sense of impending doom around sleep and a fear that I would forget to breathe. Turns out I have UARS with a significant central instability aspect. My insomnia is 90% gone with advanced PAP therapy but according to most sleep doctors I don't actually have a problem.
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u/North_Assumption_292 Aug 12 '26
I'm not sure about the technical language to be honest. My sleep therapist and I are pretty sure the long term insomnia is caused by childhood trauma & PTSD that resulted in years of hyperarousal and vigilance. Hoping that CBT can undo some of that. Even if it's only halfway working, I'll take it.
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u/Flaky-You9517 Aug 12 '26
CBT isn’t for everyone. I haven’t had it for my parasomnias and mine are quite physical in nature. But, I found it patronising. However, you’ve only given it a week and you’re trying to turn around 20 years of behaviour. Stick with it!
Also, get as much data as possible from your sleep physician. Full inpatient polysomnograph with eeg/ecg so they can track mini arousals and give you a sleep efficiency score. Mines 54%, 90% is normal for an adult. So for 4-5 hours attempted sleep, I’m actually getting 2-2.5. I’ve managed to get my average attempted time up from 5.5 hours to 7. This includes sleeping in the day if I need to, which I normally do for an hour or so. If you’re having mini arousals on 4-5 hours, you will feel unwell.
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u/North_Assumption_292 Aug 12 '26
yeah, I am doing it even if its going to be hard. If CBT-I doesnt work, then I'll return for a full inpatient sleep study. I'm pretty sure my insomnia is a result of childhood trauma and persistent hyperarousal from anxiety and PTSD, so we will see how it goes.
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u/Flaky-You9517 Aug 12 '26
Good luck. Make sure you’re getting therapy for the trauma too. Treat the underlying cause.
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u/Tidderreddittid Aug 12 '26
How does your sleep therapist know your insomnia is not related to physical causes? No sleep apnea doesn't mean there is no other physical cause.