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CBT-I: The First Line Treatment for Chronic Insomn ...
CBT-I Webinar Recording
CBT-I Webinar Recording
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Video Summary
The webinar introduced an advanced addiction psychotherapy series hosted by the American Academy of Addiction Psychiatry in partnership with OHSU and NYU, then focused on Cognitive Behavioral Therapy for Insomnia (CBT-I), presented by Dr. Vassarman. Dr. Vassarman explained that CBT-I is the most effective treatment for chronic insomnia and is especially useful for patients with substance use disorders, since insomnia is common in addiction and can worsen relapse risk. She reviewed basic sleep science, including sleep stages, circadian rhythm, sleep need across the lifespan, and why people with insomnia often misperceive how little they sleep. She then walked through the CBT-I protocol: - <strong>Assessment and sleep logging</strong> to understand sleep patterns, caffeine/substance use, daytime habits, and nighttime behaviors. - <strong>Cognitive restructuring</strong> to challenge unhelpful beliefs such as “I’ll never function tomorrow” or “I need eight hours.” - <strong>Sleep scheduling/sleep efficiency</strong> to consolidate sleep by setting a regular wake time and limiting time in bed to about average sleep time plus one hour. - <strong>Stimulus control</strong> so the bed is associated only with sleep and sex, not wakefulness. - <strong>Relaxation training</strong> introduced later in treatment to reduce daytime arousal and provide a nighttime tool. - <strong>Sleep hygiene</strong> to support, though not replace, the core treatment. She also discussed relapse prevention, booster sessions, and how to adapt CBT-I for patients with substance use disorders using a harm-reduction approach. The Q&A covered practical issues such as sleep apps, exercise, diet, middle-of-the-night behavior, bipolar disorder, medication tapering, and nightmares.
Keywords
addiction psychotherapy
American Academy of Addiction Psychiatry
OHSU
NYU
Cognitive Behavioral Therapy for Insomnia
CBT-I
chronic insomnia
substance use disorders
sleep hygiene
stimulus control
relapse prevention
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