There is not one specific indicator. If you’ve had insomnia for a long period of time, if you have tried sleep medications and haven’t had significant relief, or if there’s no obvious medical or psychiatric cause you’re aware of, then it’s likely you’ll want to address your concerns about the sleep disturbance as well as habits you’ve developed over time that will perpetuate insomnia. A lot of the things people do often perpetuate insomnia. Some people take daytime naps after a bad night’s sleep, sleep in on weekends or stay in bed for extended periods of time. These things actually contribute to insomnia and they’re the habits we try to end with CBT.
Probably one of the better ways to find a CBT-I specialist would be to seek out an accredited sleep center in your area. A lot of sleep centers will have a qualified provider who can implement CBT-I, although this is not guaranteed. Also, the Society for Behavioral Sleep Medicine offers a certification in Behavioral Sleep Medicine. People who pass this exam have the skills to implement CBT-I treatment and the knowledge about how CBT-I works.
They’re experts in behavioral insomnia treatments as opposed to pharmacological treatments. They know a lot about learning theory and how learning affects the development of bad sleep. They use tools to correct the sleep-disruptive habits themselves. They’re also skilled at the cognitive therapies used to intervene in attitudes that patients have about sleep.
There are some behavioral treatment principles available online, and there are also self help books by reputable insomnia experts. Those tools generally provide all of the principles needed, but it depends on whether you’re a self-starter and if you’re really committed to following through with treatment.
The downside of seeking cognitive behavioral therapy for insomnia treatment is, particularly if people are not near a metropolitan area, it may be reasonably difficult to find someone to treat them. There are currently only 75 individuals qualified to do this. There’s a need for more people practicing behavioral sleep medicine. However, the upside is that a lot of physicians and mental health providers are taking the exam and over time they will populate sleep centers and other areas as well.
Jack D. Edinger, Ph.D. is an insomnia researcher. Content reviewed by Christopher L. Drake, PhD (December 2009)