Why Treating a Primary Mental Health Disorder Won’t Cure Insomnia
- Insomnia as a risk factor for behavioral health and medical disorders
- Treatment issues when insomnia is comorbid with depression, anxiety, and PTSD
- Sleep quality concerns with co-occurring chronic pain and illness
- What weakens sleep drive and disturbs circadian rhythms?
- Common thoughts and behaviors that contribute to sleep-interfering arousal
- How to teach clients about the 3 P’s - predisposing, precipitating, and perpetuating factors
How and What to Ask Your Clients
- Top questions for the initial interview
- Assessments for co-occurring sleep disorders
- Talking with clients about the impact of medications and drugs on sleep
- Evaluate sleep continuity, discern bad sleep habits, and identify daytime symptoms of insomnia
- Sleep diary and other take-home assessment resources
- How to get clear, useable information about your clients’ sleep patterns
Behavioral Strategies to Improve Sleep and Outcomes for Primary Mental Health Disorders
- Clinical practice guidelines and the state of research on insomnia treatment
- Who is a good candidate for CBT-I?
- Effective sleep hygiene for clients who haven’t addressed the basics
- Clock watching and its implications
- Sleep environment concerns
- Impact of eating, substances, and exercise
- Strengthen the sleep drive and circadian clock with sleep restriction therapy (SRT)
- Psychoeducation on rationale and addressing clients’ fears to increase engagement
- How to set the sleep window and when to extend time-in-bed
- Rules for before-bed activities and strategies for waking up on time
- Address conditioned arousal with Stimulus Control (SC)
- Overcoming obstacles to strengthening the association between bed and sleep
- Counter-arousal strategies
- Activities your clients can use during periods of nighttime wakefulness
- Create a buffer zone and worry schedule for your clients
- Tools to identify thoughts and beliefs that perpetuate sleep problems
- Combat intrusive thoughts during sleep time
- Help clients reduce sleep effort and worry about lack of sleep
- Strategies to restructure expectations and thoughts
- Behavioral experiments to evaluate sleeprelated thinking
Additional Factors for the Insomnia-Informed Clinician
- Best practices to address clients’ concerns about interventions
- Troubleshooting insufficient progress in CBT-I
- When to refer to a sleep specialist
- Limitations of the research and potential risks


