counselling for insomnia (cbt-i)

Chronic insomnia isn’t permanent.

Sleep is foundational to achieving good physical and mental health.

Understanding chronic insomnia.

For so long, insomnia has been seen simply as a symptom of anxiety, depression, PTSD, burnout, stress, postpartum, or a tough life transition like a new job or recent move. While that can be true, chronic insomnia persists long after the original cause of it has resolved. When left untreated or poorly managed, insufficient sleep can cause undue mental distress, mood swings, difficulties with emotional regulation, increase your risk for certain physical health conditions, and make it much more difficult to benefit from any therapy that you’re doing. This may even begin to noticeably impact your performance at work, school, or exercise, as well as your personal relationships with a partner, friends, and family.

Why CBT-I?

Maybe you’ve been worried about starting on a sleep medication. The good news is that Cognitive Behavioural Therapy for Insomnia (CBT-I) is now considered by the Canada Drug Agency as the gold-standard, first-line treatment for chronic insomnia, over sleep medication. Medications do have their place, but CBT-I is different because it helps to address insomnia directly at the root cause by targeting your routines, thoughts, behaviours, and patterns that keep insomnia hanging around. CBT-I will help you rebuild confidence that your body is definitely not broken, and that it does know how to sleep! The goal from CBT-I is that it creates lasting changes that continue well beyond treatment. Restorative sleep also strengthens your concentration, memory, energy, and resilience.

CBT-I for trauma and PTSD

CBT-I is especially valuable for individuals living with trauma, PTSD, or complex PTSD (C-PTSD), where sleep disturbances, nightmares, awareness of threats, and hyperarousal can become chronic barriers to healing. It is suggested to address insomnia alongside PTSD, also to decrease the fear of going to sleep and staying asleep.

Frequently asked questions about CBT-I

CBT-I (Cognitive Behavioural Therapy for Insomnia) is the gold-standard treatment for chronic insomnia. Rather than simply helping you “relax” or giving you tips for better sleep, CBT-I targets the patterns that keep insomnia going. It’s structured, evidence-based, and designed to create lasting improvements in your sleep.

Yes. In fact, many of the people who benefit most from CBT-I have struggled with sleep for months, years, sometimes even decades! Chronic insomnia doesn’t mean you’re “broken” or that you’re bad at sleeping. It means your brain and body have learned physiological and psychological patterns that have become the ‘new normal’ and kept your sleep disrupted. The good news is that those patterns can be changed, even after a long time.

CBT-I is now considered the first-line treatment for chronic insomnia because it addresses the root causes of insomnia, rather than temporarily fixing it with sleep medication. Sleep medication can help your sleep while you’re taking it, but the effects may go away once you stop.

Some people use sleep medication while completing CBT-I, while others don’t. If you are already on sleep medications, it is your decision whether or not to continue taking it or to modify it, but we cannot advise you on this. Please consult your family doctor when changing any existing medications. That being said, coming off of medication or starting medication is not a pre-requisite of starting CBT-I.

Most people complete CBT-I anywhere from 6-12 sessions, although this varies depending on your sleep history, adherence to the homework, and your goals. Sessions are typically spaced 1-2 weeks apart. Thankfully, the effects are also permanent when you continue to incorporate the practical strategies you’ve learned from CBT-I! You may also choose to continue to engage in therapy with your CBT-I clinical counsellor for other life matters, after you finish the program.

This is something many clients are worried about – that CBT-I is another intervention that won’t work. My clients have often tried melatonin or other natural supplements, different sleep medications, putting away their phone before bed, sleep hygiene, breathing techniques, meditation music, or sleep apps – all without any significant or lasting success, which is understandably very frustrating. CBT-I is different because it targets the underlying mechanisms that maintain chronic insomnia, rather than offering temporary solutions.

Absolutely. PTSD and C-PTSD are often associated with nightmares, hypervigilance, racing thoughts, and difficulty feeling safe. While these other symptoms can fluctuate or even subside over time, sleep disturbances have been shown to persist. Because of this, insomnia should actually be one of the first things to address if you suspect you have PTSD or C-PTSD. While CBT-I doesn’t treat trauma directly, improving your sleep can significantly reduce the emotional and mental exhaustion that make trauma symptoms harder to manage. Many people find they’re able to engage more effectively in therapy and be more present with life once their sleep begins to improve.

That’s one of the most common fears people have, and it’s completely understandable. Your body actually doesn’t forget how to sleep, it’s a very basic biological function of our bodies, and insomnia cannot undo that. CBT-I helps remove the barriers that have gotten in the way of having a restful and restorative sleep, so that your natural sleep system can do what it was designed to do.

Not always. Stress, anxiety, trauma, grief, or another major life change may be what started your sleep difficulties, but chronic insomnia often becomes its own disorder. Even after the original stressor has improved, the insomnia can continue because the brain has learned to associate the bed or bedtime with wakefulness instead of sleep.

when you’re ready

Take the first step toward sleeping again.

If you’re ready to finally get some real rest and you’re searching for CBT-I in Vancouver, a “sleep therapist near me,” or counselling for insomnia in Vancouver, Lavender Grove Counselling is here to help. Your journey toward restful, restorative sleep begins here.