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
15 minutes ago
- Yahoo
Texas A&M mascot Reveille has eye removed after glaucoma diagnosis
Texas A&M announced Wednesday that Reveille X, the school's mascot, had to have an eye removed during surgery after she was diagnosed with glaucoma. The collie has served as A&M's mascot since April 30, 2021, when Reveille IX retired. Reveille is a central part of gameday activities at Texas A&M and runs out on the field ahead of home games before taking her normal spot on the sidelines. 'Under the watchful eye of her Mascot Corporals, it came to our attention that Miss Rev has been experiencing some discomfort and cloudiness in her right eye,' A&M president Mark Welsh said in a statement. Sadly, the issue has progressed and during a recent check-up, she was diagnosed with glaucoma. At the recommendation of our world-class veterinarians at the Texas A&M Veterinary Medical Teaching Hospital, Miss Rev underwent surgery earlier [Wednesday] to relieve any discomfort. During surgery, the veterinary team discovered signs of abnormal tissue, and out of an abundance of caution, removed her eye. The tissue was sent to an ocular pathologist for evaluation, which is standard practice.' Welsh said in his statement that Reveille would not make any public appearances while she recovers from her surgery, but that the school 'can expect Miss Rev to be back to enjoying all her favorite activities — cruising on Rev Force One, attending classes, cheering on the Aggies, and keeping our campus squirrels in line - this fall.' The first Reveille was adopted by A&M students in the 1930s and the mascot is officially listed as the highest-ranking member of school's Corps of Cadets. Members of the corps take care of Reveille and she goes everywhere with her caretakers and she's the only non-service dog allowed on campus building. According to Texas A&M tradition, if Reveille barks during a class she's in, the class is canceled.


New York Times
16 minutes ago
- New York Times
Kennedy Rescinds Endorsements for Some Flu Vaccines
Health Secretary Robert F. Kennedy Jr. on Tuesday formally rescinded federal recommendations for all flu vaccines containing thimerosal, a mercury-based preservative that the anti-vaccine movement has falsely linked to autism. The decision cements a move last month by vaccine advisers whom Mr. Kennedy named to the federal Advisory Committee on Immunization Practices after abruptly firing all 17 previous members. After hearing a presentation by the former leader of an anti-vaccine group, the panel had voted to walk back federal recommendations for all flu vaccines containing thimerosal. The decision will not affect most Americans seeking flu vaccines: Thimerosal is added to multidose vials of flu vaccines to prevent bacteria from growing, but it is not an ingredient of the single-dose vials administered to most people. During the 2024-25 respiratory virus season, only 3 percent of children and 2 percent of older adults received flu vaccines containing thimerosal, according to an analysis of electronic health records by Truveta, a company that analyzes such records. Still, multidose vials are needed in places where it is difficult to store many vaccines, such as nursing homes or mobile clinics serving remote rural areas. Mr. Kennedy's sign-off does not withdraw vaccines containing thimerosal from the market. But his rescinding the federal recommendation means that such shots may not be available to Americans, because insurance companies are no longer required to cover them. 'We urge global health authorities to follow this prudent example for the protection of children worldwide,' Mr. Kennedy said in a statement. Vaccine manufacturers have confirmed that they have the capacity to replace multidose vials containing mercury, ensuring that vaccine supplies for children and adults will 'remain uninterrupted,' the Department for Health and Human Services said in a statement. Federal health officials began removing thimerosal from childhood vaccines about 25 years ago, citing an abundance of caution despite a lack of data supporting safety concerns. Dozens of studies have shown thimerosal to be harmless. But the anti-vaccine community has long falsely maintained that the ingredient can cause neurological problems. At a meeting of the vaccine advisers last month, Lyn Redwood, a former leader of Children's Health Defense, the anti-vaccine group founded by Mr. Kennedy, claimed thimerosal was dangerous and toxic to children. Her presentation incorrectly said the only flu vaccine still containing thimerosal had 50 micrograms per dose, double the actual amount. The seven new advisers voted 5-1, with one abstention, to withdraw recommendations for flu vaccines containing thimerosal for children, pregnant women and other adults. The director of the Centers for Disease Control and Prevention typically accepts the recommendations of the committee. But the agency does not currently have a leader, and so the decision fell to Mr. Kennedy.


Fox News
17 minutes ago
- Fox News
At-home test works like coffee rings to spot serious illness faster
Have you ever noticed how a spilled cup of coffee leaves behind a telltale brown ring? While those stains might be annoying, the science behind them, known as the coffee ring effect, has sparked innovations in health technology. UC Berkeley researchers recently turned this everyday phenomenon into a breakthrough medical test, making rapid and reliable disease detection as easy as brewing your morning coffee. Curious how a simple coffee stain could inspire cutting-edge diagnostics and revolutionize at-home testing? Let's look at how a forgotten mug on your desk might just save lives. Ever wondered why spilled coffee, wine or tea dries in a ring rather than evenly? This common pattern is known as the "coffee ring effect." The phenomenon occurs because of the liquid's surface tension. As the drop begins to dry, water at the edges evaporates more quickly since that area is thinner. To keep up, liquid from the center flows outward, carrying tiny particles with it. Once the drop is completely dry, these particles settle along the edge, creating the signature ring stain you see on tables and countertops every day. Surprisingly, that annoying coffee ring on your table has inspired a major breakthrough in medical technology. Researchers at UC Berkeley transformed this everyday nuisance into a powerful new at-home diagnostic test. This innovative test can identify diseases like COVID-19, prostate cancer and sepsis with remarkable accuracy. In fact, it is up to 100 times more sensitive than many current rapid tests. Even better, it delivers results in just twelve minutes, depending on the test. The idea began with Kamyar Behrouzi, a former Ph.D. student at UC Berkeley. While developing a COVID-19 biosensor in 2020, he noticed that virus particles, much like coffee particles, tend to gather at the edge of a droplet. By using this natural effect, the researchers designed a test that captures and concentrates disease markers, making detection much easier. Thanks to this stain-inspired science, fast and reliable testing is now possible right at home. So, how does this innovative test actually work? First, you place a small sample from your nose or cheek onto a special membrane. As the sample dries, disease proteins concentrate at the edges to form a visible ring. Next, you add a second droplet containing light-reactive particles. If certain disease biomarkers are present, these nanoparticles light up when exposed to light. You can see positive results with the naked eye in some cases, or verify them more accurately using a special AI-powered smartphone app. This rapid test does more than detect COVID-19. It can also identify early signs of sepsis, a life-threatening infection that needs quick treatment. To make home testing accessible, the UC Berkeley team even created a 3D-printed prototype for easy use on your kitchen counter. According to professor Liwei Lin, this innovative approach could transform regular health screening, with no lab visit required. This coffee ring-inspired test brings hospital-level disease detection right to your home. With results ready in under twelve minutes, you can quickly check for diseases like COVID-19 and even early signs of sepsis. You no longer need to schedule lab visits or wait days for results. Instead, you can take charge of your health from the comfort of your kitchen, using a simple, affordable tool that could catch problems early and help keep your family safe. As technology like this becomes widely available, routine screening could become as easy as making your morning coffee. It's incredible how a common coffee stain inspired a breakthrough in medical testing. Science proves that even life's little messes can spark big innovations. With these advances, you can look forward to faster, easier health checks at home and maybe appreciate your next coffee spill just a little more. Would you trust a coffee stain to help catch disease early? Let us know by writing us at Sign up for my FREE CyberGuy ReportGet my best tech tips, urgent security alerts, and exclusive deals delivered straight to your inbox. Plus, you'll get instant access to my Ultimate Scam Survival Guide - free when you join my Copyright 2025 All rights reserved.