Insomnia Disorder Treatment in Sycamore and North Aurora IL
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If you are interested in counseling for Insomnia, call OakHeart at 630-570-0050 or 779-201-6440 or email us at [email protected]. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.
Many people have experienced some form of insomnia at some point in their lives, and approximately 5-10% of adults experience chronic insomnia (Sateia et al., 2017). Chronic insomnia can develop on its own or as a consequence of another medical or mental health condition, substance use, medication side effects, or another sleep disorder such as obstructive sleep apnea. Whatever the cause, insomnia can significantly affect mood, cognitive functioning, physical health, work and school performance, and overall quality of life.
What is Insomnia Disorder?Insomnia is classified in the DSM-5-TR as a Sleep-Wake Disorder characterized by poor sleep quantity or quality (American Psychiatric Association, 2022). Symptoms include difficulty falling asleep, difficulty staying asleep (e.g., frequent awakenings and/or difficulty falling back to sleep after waking), and/or waking up too early in the morning and being unable to fall back asleep. To meet criteria for chronic insomnia, these symptoms must occur at least three nights per week, persist for at least three months, and cause clinically significant distress or impairment in important areas of functioning (e.g., work, school, relationships).
Insomnia is associated with a range of consequences when left untreated, including increased risk for depression and anxiety disorders, difficulty regulating emotions, impaired memory and concentration, decreased quality of life, increased risk of accidents (including motor vehicle accidents), and worsened physical health outcomes including cardiovascular disease, metabolic disease, and immune dysfunction (Roth, 2007). Insomnia frequently co-occurs with and can be worsened by other conditions, including:
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When insomnia co-occurs with another condition, both can typically be addressed simultaneously, and treating the insomnia often improves the co-occurring condition as well.
Is OakHeart the Right Fit for Your Insomnia Treatment Needs?
OakHeart provides Cognitive Behavioral Therapy for Insomnia (CBT-I), a structured, evidence-based psychotherapy that is recommended as the first-line treatment for chronic insomnia by the American Academy of Sleep Medicine (Edinger et al., 2021). We are an outpatient mental health practice. We do not provide:
If you suspect you may have a sleep disorder other than insomnia (e.g., loud snoring, witnessed pauses in breathing, excessive daytime sleepiness despite adequate sleep time, restless legs symptoms), a referral to a sleep medicine physician or sleep clinic for a sleep study is the appropriate next step. Your primary care provider can refer you to a sleep clinic. CBT-I can also be appropriate concurrent with or following treatment of another sleep disorder, and we work in coordination with your medical providers when relevant.
- Sleep studies or polysomnography
- Diagnosis or treatment of obstructive sleep apnea (OSA), restless legs syndrome (RLS), periodic limb movement disorder, narcolepsy, or other sleep medicine conditions
- CPAP or BiPAP management
- Prescribing or managing sleep medications
If you suspect you may have a sleep disorder other than insomnia (e.g., loud snoring, witnessed pauses in breathing, excessive daytime sleepiness despite adequate sleep time, restless legs symptoms), a referral to a sleep medicine physician or sleep clinic for a sleep study is the appropriate next step. Your primary care provider can refer you to a sleep clinic. CBT-I can also be appropriate concurrent with or following treatment of another sleep disorder, and we work in coordination with your medical providers when relevant.
What is Cognitive Behavioral Therapy for Insomnia (CBT-I)?
CBT-I is a structured, time-limited treatment (typically 6-8 sessions) that targets the behavioral and cognitive factors that maintain insomnia. Multiple studies have shown CBT-I to be as effective as medication in the short term and more effective than medication in the long term, with effects that persist after treatment ends because the underlying patterns have been changed rather than masked (Manber et al., 2014; Muench et al., 2022).
CBT-I includes the following components, which are introduced progressively across sessions:
Sleep Assessment and Sleep Logs. The first phase involves a detailed assessment of your sleep history, current sleep patterns, contributing factors, and any co-occurring conditions. You will begin keeping a daily sleep log to track sleep onset, awakenings, total sleep time, and other variables. The sleep log is used throughout treatment to monitor progress and tailor interventions.
Psychoeducation. Education on the biology of sleep, sleep architecture, the regulation of sleep and wakefulness (sleep drive and circadian rhythm), and the factors that maintain insomnia. Understanding what is actually happening in your body and brain when you cannot sleep is often clarifying and reduces some of the anxiety that perpetuates insomnia.
Stimulus Control. A set of behavioral instructions designed to re-associate the bed and bedroom with sleep rather than with wakefulness and frustration. This typically includes guidelines such as going to bed only when sleepy, using the bed only for sleep, getting out of bed if unable to sleep, and maintaining a consistent wake time.
Sleep Restriction Therapy. A counterintuitive but highly effective intervention that temporarily limits time in bed to match the amount of sleep you are actually getting, then gradually expands it as sleep efficiency improves. Sleep restriction increases sleep drive, consolidates sleep, and is often the component of CBT-I that produces the most dramatic improvements. Because sleep restriction involves a temporary period of increased sleep deprivation before sleep efficiency improves, it is important that this component is delivered by a clinician with specialized training in CBT-I. Sleep restriction is contraindicated or requires significant modification for individuals with bipolar disorder (because sleep deprivation can trigger manic or hypomanic episodes), seizure disorders (because sleep deprivation can lower the seizure threshold), certain medical conditions, and occupations involving high-stakes alertness (e.g., commercial driving, piloting). Your clinician will assess for these and related considerations before introducing sleep restriction and will adjust the protocol as appropriate.
Cognitive Restructuring. Identifying and modifying unhelpful thoughts and beliefs that maintain insomnia (e.g., catastrophic predictions about the consequences of a bad night, beliefs about how much sleep is needed, anxiety about being able to sleep). Many people with chronic insomnia have developed a complicated relationship with sleep itself, and addressing that cognitive layer is often essential.
Relaxation Strategies. Techniques such as progressive muscle relaxation, diaphragmatic breathing, and guided imagery can support the transition to sleep, particularly for individuals whose insomnia is closely tied to physiological arousal or anxiety.
Sleep Hygiene Education. Sleep hygiene refers to lifestyle and environmental factors that affect sleep (e.g., caffeine and alcohol use, screen exposure, light exposure, exercise timing, room temperature, noise). While sleep hygiene alone is generally insufficient to treat chronic insomnia, addressing significant sleep hygiene issues is an important supporting component.
Relapse Prevention. Toward the end of treatment, your clinician will work with you to anticipate situations that could trigger a return of insomnia symptoms (e.g., stress, travel, illness, life transitions) and to develop a plan for applying what you have learned to maintain gains over time.
CBT-I includes the following components, which are introduced progressively across sessions:
Sleep Assessment and Sleep Logs. The first phase involves a detailed assessment of your sleep history, current sleep patterns, contributing factors, and any co-occurring conditions. You will begin keeping a daily sleep log to track sleep onset, awakenings, total sleep time, and other variables. The sleep log is used throughout treatment to monitor progress and tailor interventions.
Psychoeducation. Education on the biology of sleep, sleep architecture, the regulation of sleep and wakefulness (sleep drive and circadian rhythm), and the factors that maintain insomnia. Understanding what is actually happening in your body and brain when you cannot sleep is often clarifying and reduces some of the anxiety that perpetuates insomnia.
Stimulus Control. A set of behavioral instructions designed to re-associate the bed and bedroom with sleep rather than with wakefulness and frustration. This typically includes guidelines such as going to bed only when sleepy, using the bed only for sleep, getting out of bed if unable to sleep, and maintaining a consistent wake time.
Sleep Restriction Therapy. A counterintuitive but highly effective intervention that temporarily limits time in bed to match the amount of sleep you are actually getting, then gradually expands it as sleep efficiency improves. Sleep restriction increases sleep drive, consolidates sleep, and is often the component of CBT-I that produces the most dramatic improvements. Because sleep restriction involves a temporary period of increased sleep deprivation before sleep efficiency improves, it is important that this component is delivered by a clinician with specialized training in CBT-I. Sleep restriction is contraindicated or requires significant modification for individuals with bipolar disorder (because sleep deprivation can trigger manic or hypomanic episodes), seizure disorders (because sleep deprivation can lower the seizure threshold), certain medical conditions, and occupations involving high-stakes alertness (e.g., commercial driving, piloting). Your clinician will assess for these and related considerations before introducing sleep restriction and will adjust the protocol as appropriate.
Cognitive Restructuring. Identifying and modifying unhelpful thoughts and beliefs that maintain insomnia (e.g., catastrophic predictions about the consequences of a bad night, beliefs about how much sleep is needed, anxiety about being able to sleep). Many people with chronic insomnia have developed a complicated relationship with sleep itself, and addressing that cognitive layer is often essential.
Relaxation Strategies. Techniques such as progressive muscle relaxation, diaphragmatic breathing, and guided imagery can support the transition to sleep, particularly for individuals whose insomnia is closely tied to physiological arousal or anxiety.
Sleep Hygiene Education. Sleep hygiene refers to lifestyle and environmental factors that affect sleep (e.g., caffeine and alcohol use, screen exposure, light exposure, exercise timing, room temperature, noise). While sleep hygiene alone is generally insufficient to treat chronic insomnia, addressing significant sleep hygiene issues is an important supporting component.
Relapse Prevention. Toward the end of treatment, your clinician will work with you to anticipate situations that could trigger a return of insomnia symptoms (e.g., stress, travel, illness, life transitions) and to develop a plan for applying what you have learned to maintain gains over time.
Frequently Asked Questions
How is CBT-I different from sleep medication? Sleep medications can be helpful for short-term use but do not address the underlying behavioral and cognitive patterns that maintain chronic insomnia. When medication is discontinued, sleep difficulties often return. CBT-I targets the patterns themselves, with effects that persist after treatment ends. CBT-I is also free of the side effects, tolerance, and dependence concerns associated with many sleep medications. Decisions about medication should be made with your prescribing provider, and many clients work on CBT-I while continuing or tapering sleep medications under medical supervision.
How long does CBT-I take? CBT-I is typically structured as a 6-8 session protocol delivered weekly or biweekly. Many clients begin to see meaningful improvement within the first 2-4 weeks. The structured, time-limited nature of CBT-I is a feature, not a limitation, and is one of the things that distinguishes it from open-ended insomnia treatment.
I have tried sleep hygiene and it did not work. Is CBT-I just more sleep hygiene? No. Sleep hygiene is one small component of CBT-I, and on its own it is generally not sufficient to treat chronic insomnia. The active ingredients of CBT-I are stimulus control, sleep restriction, and cognitive restructuring, none of which are typically included in standard sleep hygiene advice. Many clients who have tried sleep hygiene without benefit are surprised by how different CBT-I feels.
Will I have to give up my sleep medication to do CBT-I? No. CBT-I can be done while continuing sleep medication. Many clients find that they are able to taper or discontinue sleep medication over time as their natural sleep improves, but this is done in coordination with the prescribing provider and is not a precondition for starting CBT-I.
What if my insomnia is caused by anxiety, depression, or trauma? CBT-I is effective for insomnia that co-occurs with other mental health conditions, and treating the insomnia often improves the co-occurring condition as well. In many cases, addressing the underlying condition concurrently produces the best outcomes. Your clinician will discuss with you whether to address the insomnia first, the co-occurring condition first, or both simultaneously.
Can I do CBT-I via telehealth? Yes. CBT-I translates well to telehealth and is delivered effectively via video sessions. All of the components, including sleep logs, psychoeducation, stimulus control, and sleep restriction, can be implemented through telehealth without loss of effectiveness.
How long does CBT-I take? CBT-I is typically structured as a 6-8 session protocol delivered weekly or biweekly. Many clients begin to see meaningful improvement within the first 2-4 weeks. The structured, time-limited nature of CBT-I is a feature, not a limitation, and is one of the things that distinguishes it from open-ended insomnia treatment.
I have tried sleep hygiene and it did not work. Is CBT-I just more sleep hygiene? No. Sleep hygiene is one small component of CBT-I, and on its own it is generally not sufficient to treat chronic insomnia. The active ingredients of CBT-I are stimulus control, sleep restriction, and cognitive restructuring, none of which are typically included in standard sleep hygiene advice. Many clients who have tried sleep hygiene without benefit are surprised by how different CBT-I feels.
Will I have to give up my sleep medication to do CBT-I? No. CBT-I can be done while continuing sleep medication. Many clients find that they are able to taper or discontinue sleep medication over time as their natural sleep improves, but this is done in coordination with the prescribing provider and is not a precondition for starting CBT-I.
What if my insomnia is caused by anxiety, depression, or trauma? CBT-I is effective for insomnia that co-occurs with other mental health conditions, and treating the insomnia often improves the co-occurring condition as well. In many cases, addressing the underlying condition concurrently produces the best outcomes. Your clinician will discuss with you whether to address the insomnia first, the co-occurring condition first, or both simultaneously.
Can I do CBT-I via telehealth? Yes. CBT-I translates well to telehealth and is delivered effectively via video sessions. All of the components, including sleep logs, psychoeducation, stimulus control, and sleep restriction, can be implemented through telehealth without loss of effectiveness.
Insomnia Related Blogs:
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The sleep cycle is comprised of 4 stages and all play a role in getting quality rest. One of the 4 stages is referred to as REM (rapid eye-movement) and the other 3 stages are part of the NREM (non-REM). Stage 1, also referred to as N1 is a very light sleep and typically lasts about 1-5 minutes. It is easy to wake a person up during this stage. Stage 2 (N2) is a deeper, more restorative sleep and lasts for approximately 10-60 minutes. During this stage, body temperature drops, muscles relax, and breathing and heart rate slow down. Stage 3 (also known as N3, Slow wave or Delta Sleep) is the deepest stage of sleep that helps consolidate memories and typically lasts for 20-40 minutes. Muscle tone, pulse, and breathing rate continue to decrease during this stage. Experts suggest that this stage is crucial for recovery and growth. Finally, REM is the 4th stage of sleep and lasts for 10-60 minutes. Much of dreaming happens during REM sleep. Research suggests that REM sleep is essential for functions such as learning and creativity (Suni, 2022)...(to read more, click on the link above).
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CBT-I addresses behaviors and thinking patterns that interfere with sleep (Manber et al., 2014). In treatment, you can expect a thorough examination of your sleep patterns and habits followed by a structured and brief treatment (typically 6-8 sessions) that assists in creating new patterns. According to many studies, CBT-I is as effective as medication in the short term and more effective than medication in the long term (as cited in Muench et al., 2022). Why? Because we may become tolerant of medications but behavioral and cognitive changes can be maintained over time...(to read more, click on the link above).
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Imagine this scenario. You have to be up early the next day. You head to bed, lie down, and when your head hits the pillow, you feel wide awake. Or, you’re sleeping soundly and then suddenly you wake up, look at the clock and see that it is 3:30am. Anxiety and worries about not falling back to sleep start kicking in. Once this occurs, it can be incredibly difficult to get back to sleep. Grounding exercises can be very useful for calming anxiety and promoting sleepiness. A grounding technique refers to a coping strategy that helps an individual refocus on the present moment. It is often used to help people who struggle with issues such as anxiety, PTSD, and panic attacks. The 5-4-3-2-1 technique is a grounding exercise in which an individual is guided to use their 5 senses to focus on the present moment. For example, a person may be asked to do the following:..(to read more, click on the link above).
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Resources
General Information
Education and Information American Academy of Sleep Medicine: aasm.org Society of Behavioral Sleep Medicine: behavioralsleep.org National Sleep Foundation: thensf.org Sleep Education (AASM patient resource): sleepeducation.org
Finding a Sleep Medicine Physician AASM Sleep Center Locator: sleepeducation.org/sleep-center
Education and Information American Academy of Sleep Medicine: aasm.org Society of Behavioral Sleep Medicine: behavioralsleep.org National Sleep Foundation: thensf.org Sleep Education (AASM patient resource): sleepeducation.org
Finding a Sleep Medicine Physician AASM Sleep Center Locator: sleepeducation.org/sleep-center
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
Edinger, J. D., Arnedt, J. T., Bertisch, S. M., Carney, C. E., Harrington, J. J., Lichstein, K. L., Sateia, M. J., Troxel, W. M., Zhou, E. S., Kazmi, U., Heald, J. L., & Martin, J. L. (2021). Behavioral and psychological treatments for chronic insomnia disorder in adults: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 17(2), 255-262.
Manber, R., Friedman, L., Siebern, A. T., Carney, C., Edinger, J., Epstein, D., Haynes, P., Pigeon, W., & Karlin, B. E. (2014). Cognitive behavioral therapy for insomnia in veterans: Therapist manual. U.S. Department of Veterans Affairs.
Muench, A., Vargas, I., Grandner, M. A., Ellis, J. G., Posner, D., Bastien, C. H., Drummond, S. P., & Perlis, M. L. (2022). We know CBT-I works, now what? Faculty Reviews, 11, 4.
Roth, T. (2007). Insomnia: Definition, prevalence, etiology, and consequences. Journal of Clinical Sleep Medicine, 3(5 Suppl), S7-S10.
Sateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017). Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 13(2), 307-349.
Edinger, J. D., Arnedt, J. T., Bertisch, S. M., Carney, C. E., Harrington, J. J., Lichstein, K. L., Sateia, M. J., Troxel, W. M., Zhou, E. S., Kazmi, U., Heald, J. L., & Martin, J. L. (2021). Behavioral and psychological treatments for chronic insomnia disorder in adults: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 17(2), 255-262.
Manber, R., Friedman, L., Siebern, A. T., Carney, C., Edinger, J., Epstein, D., Haynes, P., Pigeon, W., & Karlin, B. E. (2014). Cognitive behavioral therapy for insomnia in veterans: Therapist manual. U.S. Department of Veterans Affairs.
Muench, A., Vargas, I., Grandner, M. A., Ellis, J. G., Posner, D., Bastien, C. H., Drummond, S. P., & Perlis, M. L. (2022). We know CBT-I works, now what? Faculty Reviews, 11, 4.
Roth, T. (2007). Insomnia: Definition, prevalence, etiology, and consequences. Journal of Clinical Sleep Medicine, 3(5 Suppl), S7-S10.
Sateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017). Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 13(2), 307-349.
