CBT-I in Reading

Sound like you?

Could CBT-I help your insomnia?

Everyone has the odd bad night. Insomnia is different. It keeps happening, and it starts to wear you down in the daytime. CBT-I is built for that longer pattern. It may suit you if:

If that sounds like you, you are far from alone. It doesn't matter whether you are lying awake in a flat in the town centre or a home in Caversham. The pattern is the same, and it can be changed.

The first-line treatment

What is CBT-I?

CBT-I stands for Cognitive Behavioural Therapy for Insomnia. Some people call it sleep therapy. It's a structured course of therapy, usually six to eight weekly sessions. You can do it with a trained therapist, in a group or through an online programme.

NICE, the body that sets treatment guidance for the NHS, recommends CBT-I as the first treatment for long-term insomnia. That is because it tackles the things that keep insomnia going, and the benefits tend to last after the course ends.

It's sleep training, not talking therapy

There are a lot of reasons why people struggle with sleep problems and with insomnia. There are some sleep problems that require talking therapies because their origin is psychological or related to mental health symptoms.

CBT-I is not a talking therapy. It is a specialist treatment that focuses on sleep problems that can be improved by focusing on the physiology of sleep. For this reason, the focus is more on learning practical strategies to retrain the body to sleep again. Think of it more like physiotherapy for your sleep.

A CBT-I therapist will assess your difficulties at the start of treatment to ensure this approach is the right fit first. Whether you work with a Reading therapist or an online programme, you'll keep a sleep diary, follow a plan, and practise a set of techniques each week. Insomnia is a real physical pattern. Your body clock and your sleep drive have fallen out of step, and CBT-I gets them working together again.

What to expect

What CBT-I usually involves

Every course is tailored to you, so the order and focus will vary. But whether you work with a therapist in Reading or online, most courses include these parts.

A sleep diary

You write down when you go to bed, when you sleep and when you get up. It takes two minutes a day. Most people are surprised by what it shows.

A set sleep window

Your therapist sets a window for your time in bed, usually shorter at first, so that the time you are in bed is mostly spent asleep. This is sometimes called sleep restriction. It builds up your natural pressure to sleep. As your sleep gets more solid, your time in bed is slowly increased. It can make you sleepier during the day at first, so it should only be done with a trained clinician's guidance.

Bed is for sleep

If you are awake for a long time, you get up and do something calm until you feel sleepy. This is called stimulus control. It teaches your brain that bed means sleep, not lying awake.

Handling the worry

You learn ways to deal with the racing thoughts and the clock-watching. The aim is to take the pressure off sleep, because trying hard to sleep keeps you awake.

Keeping it going

You make a plan for bad nights in the future, so that one rough week doesn't turn back into months of sleepless nights.

Your options in Reading

Where to get CBT-I in Reading

There are four main routes. Each has pros and cons.

Free talking therapy

Your GP

Your GP can refer you to local services, check for other causes of poor sleep, and tell you which online programmes are free in your area.

Online CBT-I programmes

These are apps or websites that take you through CBT-I step by step. NICE recommends one of them, Sleepio, as an option for insomnia. Whether a programme is free depends on where you live, so ask your GP or check the programme's website.

A private therapist

This is usually the quickest way to see a real person. Be careful, though. Anyone can call themselves a "CBT-I therapist". Ask whether they are accredited, for example with the British Association for Behavioural & Cognitive Psychotherapies (BABCP), and whether they have specific training in CBT-I. This will mean they have completed a specific CBT-I course in addition to CBT training. There is also an international directory of CBT-I therapists with a UK section.

What to say to your GP

You could say something like this:

"I have had trouble sleeping at least three nights a week for more than three months, and it is affecting my days. I understand NICE recommends CBT for insomnia as the first treatment. Can you refer me for CBT-I, or tell me which programme is available in Reading? If there is a long wait, what are my options in the meantime?"

Most people haven't tried it

Have you really tried CBT-I?

Lots of people in Reading say they have tried everything, including CBT. Often, what they tried was something else. This quick check can help:

Sleep hygiene and relaxation are fine, but on their own they rarely fix long-term insomnia. If your answers are mostly in the right-hand column, you haven't had CBT-I yet. That is good news, because the most effective treatment is still ahead of you.

Realistic odds

How well does CBT-I work?

CBT-I works well for many people, but not for everyone. Here are the honest numbers from research:

• About 4 in 10 people fully recover. In a large review of studies, around 41% of people who started with CBT-I no longer had insomnia months later. For people who started with sleeping tablets, it was around 28%.
• A therapist tends to beat an app. In one head-to-head study, people who saw a therapist tended to do better than people using a fully automated online programme. If you can see a therapist through the NHS or privately in Reading, that tends to be the better option. Online CBT-I still helps many people, and it is much easier to get.
• Not everyone finishes. In the same study, about 6 in 10 people using the online programme completed every session. Sticking with it through the tough early weeks matters.

So CBT-I is not a miracle cure. It is still the best first step we have, and it gives you skills you keep for life.

What's the difference?

CBT-I vs sleeping tablets

Neither one is cheating, and neither one is a failure. They do different jobs. For most people with long-term insomnia, CBT-I comes first.

Zopiclone and other Z-drugs

Taking sleeping tablets?

Maybe you were given zopiclone for a couple of weeks, and that was a long time ago. Now you worry you can't sleep without it. This is very common, and it is not your fault.

CBT-I is one of the main tools used to help people come off sleeping tablets. You don't have to stop the tablets before you start. Many people do CBT-I first, then reduce their dose slowly once their sleep feels steadier.

Your journey to better sleep

How Reading Sleep Clinic fits in

Medication for sleep problems is not a long-term solution, so it's essential to review your options for sleep help with your GP to see what else they can suggest. There are specialist sleep clinics in the NHS who can assess sleep problems that do not respond to CBT-I or short-term medication and offer further help. Your GP can work out with you if this is something you will need.

Check the cause first

When it might not be insomnia

CBT-I works best when insomnia is the main problem. Other conditions can look like insomnia, or sit alongside it, and need their own treatment.

• Sleep apnoea causes pauses in your breathing at night. You may wake again and again without knowing why. Loud snoring, gasping and heavy daytime sleepiness are signs of sleep apnoea.
• Restless legs syndrome causes an urge to move your legs in the evening. It can make it very hard to settle.
• PTSD symptoms can leave some people in a heightened physiological state which can make them feel generally anxious, restless, and struggling to sleep, often with nightmares.

Shift work can also knock your sleep out of line. Night shifts and early starts out in Earley need a different plan from standard CBT-I.

Our assessment screens for these, so you don't spend weeks on the wrong treatment.

CBT-I in Reading FAQs