Take the pressure off sleep and find your way back to restful nights
Trying harder to sleep can leave someone more awake
It’s 2 a.m., and I’m checking the clock again. If I fall asleep right now, I’ll still get four hours. Then I start worrying about how I’ll get through tomorrow on so little sleep. The more I think about the day ahead, the more urgent sleep feels. I’m exhausted, but lying here trying to make sleep happen only leaves me more tense.
Pressure around sleep is something we can understand and change together.
Insomnia can become a frustrating cycle. Checking the clock draws attention to how much sleep you’re losing, worrying about the next day increases tension, and that tension makes it even harder to fall asleep. In CBT-I, we work together to examine the thoughts and expectations that fuel this cycle and change the habits that have taught your brain to associate bed with wakefulness rather than sleep. The goal is to reduce the pressure to make sleep happen and help you develop a more natural, consistent pattern of sleep.
Understand what's keeping insomnia going and how we can change it
CBT-I applies cognitive behavioral therapy to address the patterns that can keep insomnia going. These include thoughts that create worry and pressure around sleep and habits that associate being in bed with being awake. We’ll work together to understand what’s happening with your sleep and choose practical strategies to make it easier to settle into sleep. I’ll explain the reasoning behind each step so you understand what we’re working on and why
Together, we can:
Understand your sleep patterns and choose changes together
Hi, I’m Nellie Harari, PhD, a licensed clinical psychologist. I help adults understand how thoughts, feelings, and behavior affect one another, then use that understanding to make changes. For sleep difficulties, I ask what happens before bed and what you do when you can’t sleep. We use those details to identify habits or worries that may be keeping you alert instead of relaxed.
What I offer:
Begin to feel less tense about the night ahead
Insomnia often involves several interconnected patterns, including spending long periods awake in bed, inconsistent sleep schedules, worry about the next day, and physical tension. We’ll look at which patterns may be keeping your insomnia going and identify strategies to address them. I’ll explain why each approach may help and how we can put it into practice.
Spending more time in bed doesn’t always lead to more sleep. Sleep restriction works by carefully adjusting the amount of time you spend in bed to help consolidate sleep and reduce long periods of wakefulness during the night. Before recommending a personalized sleep schedule, I’ll assess whether this approach is appropriate for you, taking into account your sleep patterns, daily responsibilities, and any safety concerns related to daytime sleepiness.
Before making changes, we discuss:
Cognitive restructuring helps you step back from these predictions and consider how accurate or helpful they really are. Together, we’ll look at what your own experiences tell you and develop a more balanced way of thinking, so a poor night’s sleep doesn’t automatically mean expecting the worst from the day ahead.
Questions we might consider include:
Insomnia can show up at the start of the night, in the middle of it, or too early in the morning. Some people deal with more than one of these patterns.
Waking briefly during the night is common. The difficulty is getting back to sleep. Checking the clock and counting the hours left adds worry right when someone is trying to settle, and a short awakening turns into a long stretch of lying awake.
Some people wake well before they planned to get up and cannot fall back asleep, even though they still feel tired. Sleep ends earlier than they want it to, and the extra time awake often goes to worrying about concentrating, staying patient or getting through the day ahead.
We begin with your sleep history: when the difficulty started, what a typical night looks like, and what you have already tried. I’ll ask about daytime habits and how sleep affects concentration, mood and everyday activities. We also look at what you think and do when you cannot sleep, so I can explain which patterns CBT-I may help change.
You can tell me what you most want to change and ask about any recommendation, including concerns about adjusting sleep habits. Before we finish, we agree on a next step and what to try or pay attention to between appointments. My goal is for you to leave with a clearer picture of what may be keeping you awake, how treatment could help and what comes next.
Understand what may be keeping you awake and how to respond
We can start with what a typical night looks like for you.
