I'm a Psychiatrist. There Are Common Myths About Sleep That Are Preventing You From Being Well Rested.
If you've struggled to fall asleep, you may have tried a slew of tips and tricks: blackout shades, leaving your phone in another room, avoiding screens before bed, and keeping your room at a cool temperature at night. Perhaps you've indulged in new sheets or a special mattress or a wearable sleep tracker, too.
Maybe these things have helped. Maybe they haven't. But there's another, more powerful approach to insomnia that's based on decades of research—and you might not even have heard of it. It works by changing our habits, questioning ideas that degrade our sleep, and bolstering our body's sleep drive. If its name is a bit of a mouthful, or its acronym a bit obscure, it makes up for it by sheer effectiveness, helping most people with insomnia slumber more contentedly.
This treatment, cognitive behavioral therapy for insomnia, or CBT-I, is recommended by experts as the first and best treatment for insomnia, over and above sleeping pills, in part because its benefits last longer, compared to medications. It helps people fall asleep faster, spend more of the night sleeping, and feel happier with their sleep. And most people, in any case, say they'd rather try behavior change for insomnia versus a drug (which is perhaps why all those wellness sleep-hygiene tips persist). As a psychiatrist who has done extra training in sleep medicine, I've seen CBT-I work.
About 10 percent of U.S. adults—or about 25 million people—suffer from insomnia, giving CBT-I vast potential. But there's a bottleneck: Traditionally, a clinical psychologist or therapist with extra training in CBT-I delivers the treatment over the course of multiple one-on-one sessions.Yet, there were just 659 behavioral sleep specialists throughout the entire U.S. as of 2016 (the most recent survey I know of). And fewer than 10 percent of clinical psychology training programs teach CBT-I. So there just aren't enough providers—not close to enough.
The good news is that the core strategies of CBT-I still work when delivered by a digital app, or even, to an extent, by self-help booklets. So anyone who puts these principles into practice is likely to get some relief—maybe even someone reading this article.
The 'cognitive' element—the C in CBT-I—seeks to dispel unrealistic ideas about sleep, pessimism about our power to improve our sleep, and the rush to blame sleep problems when we don't feel good. The theory is that certain beliefs—like the idea that we need eight hours, or that a bad night's sleep guarantees a lousy next day—worsen worries about sleep. These worries seem to activate our stress system and make it harder to fall asleep and stay asleep, triggering a vicious cycle of pessimism about sleep that makes sleep poorer. CBT-I tries to put a stop to this.
It really is a myth, by the way, that everyone needs their eight hours. The experts recommend seven, not eight, as the minimum number of hours for an adult. And it's also a myth that something is wrong if you don't sleep straight through the night. In clinic, I've found that some patients get relief just from learning that waking up once or twice during the night is part of normal, healthy sleep. A 2014 study that looked at the sleep diaries of 592 adults without sleep disorders found an average of 1.4 awakenings per night.
But it's not just how you think. It's also what you do. And while CBT-I does include sleep hygiene tips like avoiding caffeine and bright screens before bed, these maneuvers haven't been found to work well for insomnia, at least not on their own. CBT-I's main behavioral directives—the B in CBT-I—are probably less familiar: cutting back on time in bed, changing your habits for getting in and out of bed, and waking up at the same time each day (no matter when you fall asleep).
It may seem kind of ironic to ask someone trying to get more sleep to cut down on their time in bed. But restricting time in bed is one of the most powerful levers we have to make it easier to fall asleep and stay asleep. In traditional CBT-I, the person with insomnia brings a two-week sleep diary to one of those all-too-hard-to-find behavioral sleep specialists, who tallies up how much time that person is sleeping every 24 hours, on average. Then, the dissatisfied sleeper adjusts their time in bed to that number. If they were, for instance, spending nine hours in bed each night, but only sleeping for six and tossing and turning for three, they'd start going to bed later, getting up earlier, or both, thus trimming their time in bed down to six hours. The idea is to work with your body and what it's currently capable of, rather than clinging to the wish for longer sleep when it just isn't happening.
Cutting back on time in bed works partly through mild sleep deprivation, which makes you sleepier. And when you're sleepier, it stands to reason, you sleep more easily. (Just note that if you need to drive or operate heavy machinery, you should cut back on time in bed gradually, and track your daytime sleepiness. It's never safe to drive while sleepy.) As treatment progresses, if the once fitful sleeper finds they're sleeping longer and more easily, they extend their time in bed to match their newfound sleep ability. By doing this, you can actually train your body over time into getting more sleep, with small gains in average length of sleep at the end of a course of traditional CBT-I, and with sleep time continuing to increase, for some, even weeks or months after the end of active treatment.
If you find yourself balking at the idea of cutting back on your time in bed abruptly, there's a gentler way called sleep compression. This cuts back on time in bed more slowly, by 15 to 30 minutes each week, until sleep improves. With sleep compression, you can also stop, or reverse course and extend time in bed again, if you start to feel sleepier during the day. In one study, sleep compression and sleep restriction racked up similar gains in sleep satisfaction at 10 weeks.
So, you cut back on time in bed. But the hypothetical patient who was getting six hours of sleep still wouldn't force themself to stay in bed for six hours no matter what. This brings us to the next behavioral prong of CBT-I: changing your habits for getting in and out of bed. Since 1972, when the pioneering sleep psychologist Richard Bootzin first proposed these instructions in a case report, they have been thoroughly investigated in different variations. Two key instructions are: Don't go to bed until you feel sleepy (even if it's already your new, sleep-restricted bedtime), and don't stay in bed if you can't sleep. If you can't sleep, try a relaxing low-light activity like reading, or listening to music or a podcast in the living room—and then return to bed when you're ready. The classic thinking is that this breaks the association with bed as a place of frustration, and restores it as a cue for slumber. It's also possible that it simply encourages the kind of sleep that's most likely to succeed—that is, going to sleep when you're sleepy, rather than trying to sleep whenever you just really wish you could fall asleep. (If you can't or just don't want to get out of bed, by the way, a couple of older studies do suggest that doing the same kind of relaxing low-light activities in bed when you can't sleep might still help with insomnia, at least to some degree.)
No matter when you end up going to bed, or how often you wake up during the night, CBT-I also teaches patients to get up at (roughly) the same time each day. And there are two reasons why this matters. First, the later and the more often you sleep in, the more you tend to push back your body's internal biological clock—known as the circadian clock—which pushes your body's internal bedtime later too, making it harder to fall asleep when you want to. The second reason is that getting up later and keeping your bedtime the same shortens the length of your day, which means less time awake building up your drive to sleep, and less success at bedtime. If you woke up at noon, for instance, and then tried to go to bed at 6 p.m., you just wouldn't have built up enough sleep drive yet. And the same idea applies to more subtle shortening of the span of daytime wakefulness, like waking up late or napping.
CBT-I works well. But no single treatment works for everyone, and no treatment is free of hazard. In particular, those at high risk of falls should skip getting out of bed when they can't sleep. And again, please don't drive if you're experiencing daytime sleepiness.
Sometimes, too, insomnia is the harbinger of a different problem. So if your sleeplessness is unrelenting, you're waking up at night gasping for air (a symptom of sleep apnea), or if you have the strong urge to move your lower limbs at night (an ailment called restless legs syndrome), please look up a sleep specialist who can help get you a diagnosis and hopefully some relief. In the meantime, tell your friends about CBT-I. More people should know.

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
16 minutes ago
- Yahoo
Can peptides really help erase wrinkles? Dermatologists weigh in
In you've shopped for any kind of skin care products over the past year, you've probably noticed peptides popping up everywhere. As the beauty world's trendiest, anti-aging ingredient du jour, these small chains of amino acids (which are the building blocks of proteins) are now present in everything from lip plumpers to hair-growth tonics. But experts say their most promising use is as part of an effective daily skin care routine, where research suggests they may in fact have a Botox-like effect on wrinkles by softening fine lines, building collagen and brightening and plumping wizened skin as they go. How do peptides work? "In skin care, peptides are used to mimic natural processes in the skin and encourage anti-aging effects like collagen production, skin repair and improv[ed] elasticity," says board-certified dermatologist and facial plastic surgeon Dr. Akshay Sanan. "As we age, collagen production declines, leading to wrinkles, sagging, and thinner skin. Signal peptides, like Matrixyl and copper peptides send messages to skin cells, essentially 'telling' them to produce more collagen, elastin and other structural proteins to keep the skin firm and plump." Sanan says peptides also strengthen the skin barrier, protecting against moisture loss and environmental damage. And, yes, "some peptides even have a 'Botox-like' effect by relaxing facial muscles and reducing the depth of wrinkles caused by repetitive movements," Sanan explains. Should you try peptides? Dermatologists I spoke with agreed that if you've reached an age when you're starting to spot wrinkles and collagen loss, it's worth adding peptides to your skin care regimen, if only for their plumping, moisturizing effects. In term of acting as a Botox-y wrinkle eraser, research suggests a quality peptide product will soften lines, though the result will be more subtle and less dramatic than that of a neurotoxin. "Collagen peptides do work to boost collagen production in the skin which may, over time, reduce the appearance of wrinkles," says Houston cosmetic surgeon Dr. Rukmini Rednam. What should I look for in a peptide serum? There are loads of types of peptides, but for the most bang for your skin care buck, experts recommend seeking out complexes with the most clinical data behind them, which essentially narrows things down to the Matrixyl 3000 blend and copper peptides. Both of which have some research to back up their claims, with benefits that include skin barrier support, wrinkle softening and complexion brightening. How should I use a peptide serum? Peptides are one of those skin care ingredients you can add to your routine both in the morning and at night. And, as is the case with any lighter-weight serum, for best absorption, these products should be applied after cleansing your face but before you slather on heavier creams like moisturizers and sunscreens. In terms of more detailed order of operations, you can combine peptides with vitamin C and layer them with retinoids, but most skin care experts say you shouldn't mix them with an exfoliating products. Our top 5 favorite peptide serums If you have Amazon Prime, you'll get free shipping, of course. Not yet a member? No problem. You can sign up for your free 30-day trial here. (And by the way, those without Prime still get free shipping on orders of $35 or more.) The reviews quoted above reflect the most recent versions at the time of publication.
Yahoo
31 minutes ago
- Yahoo
Warren Buffett's Next Big Buy? Why This Beaten-Down Blue Chip Stock Fits His Playbook Perfectly.
Key Points Buffett understands the business of this beleaguered insurer. He would likely find its financials appealing. Buffett would almost certainly like the stock's valuation. 10 stocks we like better than UnitedHealth Group › Warren Buffett has a lot of money burning a hole in his pocket. Technically, it's Berkshire Hathaway's (NYSE: BRK.A) (NYSE: BRK.B) pocket, but Buffett gets to decide how to use the cash. And when I say a lot of money, I mean a lot of money: Berkshire's cash position totaled nearly $348 billion at the end of the first quarter. The problem is that Buffett can't find many stocks to buy that meet his stringent investment criteria. However, I think there's one beaten-down blue chip stock that fits his playbook perfectly. A business Buffett understands Buffett has stated on multiple occasions, in various ways, that he will only invest in a business that he thoroughly understands. In his 1996 letter to Berkshire Hathaway shareholders, he wrote: "You don't have to be an expert on every company, or even many. You only have to be able to evaluate companies within your circle of competence." Probably no business is within Buffett's circle of competence more than insurance. Berkshire generates a significant portion of its revenue from its property and casualty business. But the core principles of running an insurance business are the same regardless of what type of insurance it is. The key to success is to effectively evaluate risk and charge premiums that cover that risk while making a profit. UnitedHealth Group (NYSE: UNH) is the largest health insurer in the United States. I don't doubt that Buffett knows its business quite well. After all, he bought a stake in UnitedHealth for Berkshire's portfolio in 2006 and owned the stock for three years. Financials Buffett would find appealing UnitedHealth Group's share price has plunged more than 50% this year. The company delivered lower-than-expected results in the first quarter. It initially cut full-year guidance and then withdrew the guidance altogether. However, I suspect that Buffett would still find UnitedHealth's financials appealing. Buffett has talked about the importance of return on equity (ROE) in the past. He has hinted that 20% is his preferred ROE threshold. UnitedHealth Group's ROE over the past 12 months was 22.7%. Despite its disappointing Q1 results, UnitedHealth Group's revenue still grew $9.8 billion year over year to $109.6 billion. The company also generated a profit of nearly $6.3 billion. It had nearly $34.3 billion in cash and cash equivalents with a manageable debt load. I think Buffett would focus on UnitedHealth's hard numbers more than he would Wall Street's expectations. A price Buffett almost certainly likes Why hasn't Buffett put more of Berkshire's massive cash stockpile to work? He can't find many stocks with attractive valuations. But UnitedHealth Group has a price Buffett almost certainly likes. The healthcare stock trades at roughly 12 times trailing 12-month earnings. UnitedHealth Group's earnings multiple was significantly higher when Buffett first initiated a position in early 2006. Of course, Buffett focuses on future earnings potential. Could he be worried that UnitedHealth Group's profits will continue to all? I don't think so. The company's primary issue is that costs for some of its Medicare Advantage plans were higher than expected. Buffett knows that insurers can easily address these kinds of problems in the next year by increasing premiums. He would likely believe UnitedHealth Group's prediction that the company will return to growth in 2026. Is Buffett buying UnitedHealth Group stock? I also don't know if Buffett is buying UnitedHealth Group stock. He could be content to sit on Berkshire's cash and leave it to Greg Abel to make any big moves after Buffett steps down as CEO at the beginning of next year. What I do know, though, is that UnitedHealth Group fits Buffett's playbook. And that playbook has been enormously successful through the years. Investors wanting to emulate Buffett might want to consider buying shares of the beaten-down blue chip stock while it's a bargain -- whether or not the "Oracle of Omaha" buys it himself. Should you buy stock in UnitedHealth Group right now? Before you buy stock in UnitedHealth Group, consider this: The Motley Fool Stock Advisor analyst team just identified what they believe are the for investors to buy now… and UnitedHealth Group wasn't one of them. The 10 stocks that made the cut could produce monster returns in the coming years. Consider when Netflix made this list on December 17, 2004... if you invested $1,000 at the time of our recommendation, you'd have $634,627!* Or when Nvidia made this list on April 15, 2005... if you invested $1,000 at the time of our recommendation, you'd have $1,046,799!* Now, it's worth noting Stock Advisor's total average return is 1,037% — a market-crushing outperformance compared to 182% for the S&P 500. Don't miss out on the latest top 10 list, available when you join Stock Advisor. See the 10 stocks » *Stock Advisor returns as of July 21, 2025 Keith Speights has positions in Berkshire Hathaway. The Motley Fool has positions in and recommends Berkshire Hathaway. The Motley Fool recommends UnitedHealth Group. The Motley Fool has a disclosure policy. Warren Buffett's Next Big Buy? Why This Beaten-Down Blue Chip Stock Fits His Playbook Perfectly. was originally published by The Motley Fool
Yahoo
37 minutes ago
- Yahoo
A farewell to Ozzy, Coke's sugar high, another vaccine shake-up: The week in review
RFK shakes up vaccines again Health Secretary Robert F. Kennedy Jr. took another step toward overhauling the nation's vaccine policy when he approved the removal of thimerosal, a mercury-based preservative, from all flu vaccines despite widespread agreement in the medical community that the preservative is safe. Kennedy signed off on a recommendation from the Advisory Committee on Immunization Practices, a panel he replaced with his own appointed members in June, to stop distributing vaccines containing thimerosal, which has long been targeted by anti-vaccine groups. An operatic honor for Melania Republican lawmakers are working on a Kennedy Center production of their own: renaming the center's Opera House to the 'First Lady Melania Trump Opera House.' The House Appropriations Committee, whose spending bill funds the iconic performing arts venue in Washington, voted 33-25 for the change. Lawmakers have already agreed to spend $256.7 million on improvements to the center sought by President Donald Trump, who ousted much of the Kennedy Center's board after he took office and appointed himself chairman. He has criticized some of the center's performances and said in one visit that he 'never liked 'Hamilton' very much.' A sweet twist to the Cola wars Cane sugar: It's the real thing. A Coca-Cola made with cane sugar − not high-fructose corn syrup − is coming to the United States this fall, the company announced, just like the Coke you find overseas, including Mexico. (The long-running debate over which tastes better, U.S. Coke or Mexican Coke, has been a fierce one). The news doesn't come as a compete surprise; President Donald Trump had made a case for cane sugar Coke on social media in mid-July − 'You'll see. It's just better!' Also, not to be outdone, Pepsi announced it is launching Pepsi Prebiotic Cola this fall, in Original Cola and Cherry Vanilla, containing 5 grams of cane sugar and 3 grams of prebiotic fiber. Ozzy Osbourne, the 'Prince of Darkness,' is dead The heavy metal world has lost one of its most beloved characters, Ozzy Osbourne, at age 76, only weeks after reuniting with his original band, Black Sabbath, in England for a farewell show. Osbourne, who was infamous for his hard living (and for biting the head off a bat), exploded into stardom in a solo career and later branched into reality TV with MTV's 'The Osbournes' in the early 2000s. In 2020, he revealed he had Parkinson's disease. In a just-announced new memoir, 'Last Rites,' arriving Oct. 7, Osbourne says: 'Look, if it ends tomorrow, I can't complain. I've been all around the world. … I've done good, and I've done bad. But right now, I'm not ready to go anywhere.' Remembering Ozzy Osbourne: Life on the 'Crazy Train': The metal icon through the years All bets for 2026 are on Scottie Scheffler Scottie Scheffler, fresh off a dominating win at the British Open July 20, is at the top of his game, and you can expect he'll be there for awhile. Scheffler, 29, who also captured the PGA Championship in May and now needs only a U.S. Open victory to enter the elite group of golfers who have won the sport's grand slam of all four major championships, is now the odds-on favorite to win every major in 2026, according to BetMGM. Declared the gaming venture's Matt Wall: 'The comparisons with Tiger Woods certainly don't look out of place right now.' − Compiled by Robert Abitbol This article originally appeared on USA TODAY: A farewell to Ozzy, Coke's sugar high, the flu fight: Week in review