Good sleep hygiene also includes establishing routines which help one to wind down an hour or two before bedtime. Sleep hygiene involves changing basic lifestyle habits that influence sleep, including drinking too much alcohol, smoking or drinking caffeine late in the day, not getting regular exercise, and using smartphones and other devices at night before going to bed. Sessions may include cognitive, behavioral, and educational components, including:Ĭognitive restructuring attempts to change inaccurate or distorted thoughts about sleep. CBT-I combines several different approaches to promoting sleep and preventing insomnia. The behavioral part of CBT-I involves developing good sleep habits and learning to avoid behaviors that disrupt sleep. The first step of CBT for insomnia is to identify cognitions or beliefs that affect one’s ability to sleep, the negative thoughts and worries that prevent or interrupt sleep. The Principles of Cognitive Behavioral Therapy for Insomnia In addition, there are some options where CBT-I is delivered online or through a mobile app. CBT-I typically involves 6-8 sessions with a trained provider, although some patients require fewer sessions. While some women use certain sleep-promoting medications during pregnancy, including benzodiazepines and sedative-hypnotic agents (Z-drugs), we should consider non-pharmacologic options first, especially in women who present with new onset sleep problems.Ĭognitive-behavioral therapy (CBT) specifically designed for insomnia, also known as CBT-I, is a useful adjunct or alternative to medication. While we tend to think of sleep deprivation as a postpartum issue, sleep problems are relatively common during pregnancy, with 15% to 80% of women reporting sleep problems during the first trimester and 66% to 97% of women in the third trimester.
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