Insomnia is not just a complete lack of sleep. It also encompasses having trouble falling asleep, waking in the middle of the night, waking too early in the morning and not being able to return to sleep, and experiencing restless sleep. According to the Center for Disease Control, one in five people suffer from insomnia. Lack of enough sleep can cause: Irritability, weight gain, daytime fatigue, elevated blood pressure, exacerbation of chronic pain, depression, anxiety, and a weakened immune system. Most people need between seven and 9 hours of sleep a night. The National Institute of Health has concluded that cognitive behavioral therapy for insomnia, CBT-I, is an approved method for insomnia. It is a structured program that can be monitored by a sleep therapist that helps you overcome the underlying causes of your sleep problems, unlike sleeping pills. Sleep medications are supposed to be short-term panaceas for sleep. For example, they may be used when there is grief or during a period of high stress. The first step of CBT-I is to quit taking naps and go to bed later than usual, probably around midnight, for six weeks. Arise in the morning between 6:00 a.m. and 7:00 a.m. You will probably feel more tired during the day but the goal is that after a few days of this, you will feel very sleepy at bedtime. After 6 weeks, begin to slowly allow yourself to go to be earlier and earlier. CBT-I includes stimulus control instructions. This is a matter of exploring your sleep habits to determine behaviors that may be negatively affecting your sleep. You may find that only using your bedroom for sleep will be helpful. For example, try not to watch television or use a computer in your bedroom. If you can’t fall asleep, leave the bedroom until you are ready to sleep. Another example is that many people who cannot sleep will stare at the clock and watch the hours go by. This is not a helpful behavior, so turn your clock around or cover it with something. Dr. Donn Posner, an expert in the field of sleep medicine said, “Clock watching can only lead to worry and frustration and if nothing else, worry and frustration are ‘wind to the flame of insomnia’.” Relaxation training is another component of CBT-I. This includes meditation, visual imagery, and progressive muscle relaxation. CBT-I also includes the sleep hygiene protocol listed below. • Try to go to bed and wake up at the same time, 7 days a week. • 30 minutes of exercise in the morning or afternoon, not right before bedtime. The exception would be yoga poses or stretching. • Take a warm bath or shower prior to bedtime. • Face clock away from you so you can’t see the time. • If you haven’t fallen asleep in 20 minutes, get up and do something relaxing, such as reading and then return to bed when sleepy. • Don’t eat, work, or watch television in bed. • Silence your phone. • Keep a journal by your bed so that you can jot down whatever you start worry about when trying to sleep. Tell yourself you will deal with it tomorrow. • Don’t drink caffeine after noon. • Don’t nap during the day if you have problems sleeping at night. • Unplug from all electronic devices, including television, an hour before bedtime. There are a small number of certified Behavioral Sleep Medicine specialists throughout the United States. If that is not practical, there are CDs, books, and websites that will explain CBT-I techniques. CBT-I can help people with insomnia, depression, anxiety, and chronic pain. It requires practice and some techniques may result in an initial loss of sleep. However, if you keep at it, you will likely experience lasting results. Melinda Shaver was born and raised in Independence and returned to town two years ago to open a private psychology practice in the Professional Building. She earned her master’s degree in athletic administration and a doctoral degree in exercise science from Oklahoma State University and worked in the fitness field for many years before getting her master’s and doctoral degree in clinical psychology from Argosy University with the goal of combining her background in fitness with the field of psychology to help individuals improve their mind, body and spirit. She can be contacted at (620) 926-1286.