Frequently Asked Questions
- How do I know if I have a sleep problem?
- What is psychophysiological insomnia?
- Why is the treatment of insomnia important?
- What are the treatment options for insomnia?
- Who says that Cognitive-Behavioral Treatment of Insomnia works?
- I have tried changing my sleep habits before and it didn't help much. Why should I try CBT-I?
- How much does insomnia treatment cost?
- Do you consult with other healthcare providers?
- What if sleep isn't my only issue or if I have other things to work on?
How do I know if I have a sleep problem?
There is a wide range of what can be considered “normal” behavior when it comes to sleep. You may have a sleep problem if you do any of the following:
There is a wide range of what can be considered “normal” behavior when it comes to sleep. You may have a sleep problem if you do any of the following:
- Take more than 30 minutes to fall asleep or wake up during the night for a total of more than 30 minutes.
- Wake earlier than you want and can’t get back to sleep.
- Snore so loudly that your bed partner complains.
- Stop breathing or wake gasping for air during sleep.
- Wake feeling like you’ve hardly slept at all.
- Feel really tired or sleepy during the day in spite of having slept for at least seven hours.
- Find yourself falling asleep when you don’t mean to during the day.
What is psychophysiological insomnia?
When going to bed becomes a trigger for wakefulness. If you regularly are sleepy before entering your bedroom but then wake up when you enter, you may have psychophysiological insomnia. This occurs when the associations between bed and sleep are broken, resulting in:
When going to bed becomes a trigger for wakefulness. If you regularly are sleepy before entering your bedroom but then wake up when you enter, you may have psychophysiological insomnia. This occurs when the associations between bed and sleep are broken, resulting in:
- Negative emotions such as anxiety and frustration when it’s time to go to bed or when thinking about going to bed. Example: “I get so upset about not sleeping that I can’t sleep!”
- Physical tension in association with the bed or bedroom.
Example: “I’m falling asleep on the couch, but when I get in bed, I’m wide awake!”
- Daytime fatigue, tiredness, irritability, and perceived decrease in the ability to function. Example: “My sleep problem is so bad that I don’t make plans for the mornings because I don’t know how I’ll feel!”
Why is the treatment of insomnia important?
More and more research is showing how important sleep is to your health and to your ability to function during the day.
More and more research is showing how important sleep is to your health and to your ability to function during the day.
- Dr. Daniel Chapman at the Centers for Disease Control and Prevention (CDC) says “sleep is as important to health as eating right and getting enough physical activity.” The CDC recently labelled insufficient sleep as a "public health epidemic".
- “Growing evidence shows that a chronic lack of sleep can increase your risk of obesity, diabetes, cardiovascular disease, and infections” - From NIH (National Institute of Health) Medline Plus - Summer 2012 Issue: Volume 7 Number 2 Pages 16-17
What are the treatment options for insomnia?
There are currently two treatment options for insomnia. One is medication (e.g., Ambien, Lunesta, Sonata just to name a few). These medications work well for some people, but prolonged regular use runs the risk of physical and/or psychological dependence. Also, they address the symptoms, but not the underlying problem. After long-term use, the difficulty sleeping likely will return as soon as the medication is discontinued, sometimes worse than it was before.
The second treatment option, which has been shown to be just as effective as medication in the short-term and more effective long-term, is called Cognitive Behavioral Treatment of Insomnia, or CBT-I. CBT-I can be used to help people learn to sleep without sleeping medications.
There are currently two treatment options for insomnia. One is medication (e.g., Ambien, Lunesta, Sonata just to name a few). These medications work well for some people, but prolonged regular use runs the risk of physical and/or psychological dependence. Also, they address the symptoms, but not the underlying problem. After long-term use, the difficulty sleeping likely will return as soon as the medication is discontinued, sometimes worse than it was before.
The second treatment option, which has been shown to be just as effective as medication in the short-term and more effective long-term, is called Cognitive Behavioral Treatment of Insomnia, or CBT-I. CBT-I can be used to help people learn to sleep without sleeping medications.
Who says that Cognitive-Behavioral Treatment of Insomnia works?
CBT-I is recommended as the treatment of choice for insomnia by many organizations, including the Mayo Clinic and the Stanford University Center for Sleep Science and Medicine. It is empirically supported, which means that studies have shown it to be effective for both primary insomnia as well as insomnia secondary to several different psychiatric and medical disorders including:
CBT-I is recommended as the treatment of choice for insomnia by many organizations, including the Mayo Clinic and the Stanford University Center for Sleep Science and Medicine. It is empirically supported, which means that studies have shown it to be effective for both primary insomnia as well as insomnia secondary to several different psychiatric and medical disorders including:
- Depression
- Anxiety
- Posttraumatic Stress Disorder
- Alcoholism
- Breast cancer
- Pain disorders
- Combination of medical and psychiatric disorders (more than one present at the same time)
I have tried changing my sleep habits before and it didn't help much. Why should I try CBT-I?
Implementing recommendations may require support.
Psychological Sleep Services can help you go beyond sleep hygiene information prepared for the masses by thoughtfully designing customized sleep recommendations based on your initial comprehensive assessment. You will be educated why the recommendations are being made and supported in addressing any challenges that may come up with implementing them.
Implementing recommendations may require support.
- Simply telling someone to take some time to engage in relaxing activity before bedtime is likely not to be sufficient guidance.
- Other complications could include a partner who likes to watch TV in bed or has a different sleep schedule from you.
- Standard recommendations may not work due to other issues such as chronic pain, anxiety, depression or current stress with work or family.
- Significant customization is also needed when you are not able to sleep at times in accordance with your preferred times. For example, you may be a morning person who likes to go to bed early but has to stay up late for school or a night owl who has to get up early for work.
- Cognitive therapy targeting these beliefs and educating you further about sleep may be required for you to give the sleep recommendations a chance.
Psychological Sleep Services can help you go beyond sleep hygiene information prepared for the masses by thoughtfully designing customized sleep recommendations based on your initial comprehensive assessment. You will be educated why the recommendations are being made and supported in addressing any challenges that may come up with implementing them.
How much does insomnia treatment cost?
Because of managed care contracts, there is a range of fees and copays. I am an in-network provider for a significant number of insurance carriers. Please consider how lack of sleep may be impacting your health, productivity and relationships with others. Another thing to consider is that with medication, the treatment and costs tend to go on indefinitely, making CBT-I a far more affordable alternative over time. This may be the most important investment you ever make.
Because of managed care contracts, there is a range of fees and copays. I am an in-network provider for a significant number of insurance carriers. Please consider how lack of sleep may be impacting your health, productivity and relationships with others. Another thing to consider is that with medication, the treatment and costs tend to go on indefinitely, making CBT-I a far more affordable alternative over time. This may be the most important investment you ever make.
Do you consult with other healthcare providers?
Anyone interested in being prescribed medication to help with sleep issues will need to consult with a prescribing provider - Dr. Haraburda doesn't prescribe medication. A major goal of CBT-I is often to help transition individuals to sleeping well without medications. Dr. Haraburda can consult with your prescribing provider for any medication concerns you may have.
Anyone interested in being prescribed medication to help with sleep issues will need to consult with a prescribing provider - Dr. Haraburda doesn't prescribe medication. A major goal of CBT-I is often to help transition individuals to sleeping well without medications. Dr. Haraburda can consult with your prescribing provider for any medication concerns you may have.
- If you are currently seeing someone else for behavioral health treatment, Dr. Haraburda can consult with the person you are seeing and focus on your sleep.
- The CONTACT tab has referral form for providers.
What if sleep isn't my only issue or if I have other things to work on?
I am a licensed clinical psychologist with over 20 years of experience treating individuals with a range of psychological issues. In addition to my work in behavioral sleep medicine, I have helped many patients with anxiety, depression, and substance use disorders and continue to do so. If you are satisfied with your sleep but have other issues to work on, you can contact me to see if my experience is a good fit with your concerns.
I am a licensed clinical psychologist with over 20 years of experience treating individuals with a range of psychological issues. In addition to my work in behavioral sleep medicine, I have helped many patients with anxiety, depression, and substance use disorders and continue to do so. If you are satisfied with your sleep but have other issues to work on, you can contact me to see if my experience is a good fit with your concerns.
- CBT-I helps with more than just sleep. A recent NY Times article spoke of how sleeping better as a result of CBT-I can help individuals respond much better to treatment for depression.
- In addition to occurring by itself, insomnia can be part of anxiety and depression. It can also contribute to symptoms that linger and increase risk for relapse after treatment. Cognitive-Behavioral techniques (see below) are effective in treating a wide range of problems and were actually developed first for anxiety and depression.