We all see patients struggling with insomnia, but implementing CBT-I (cognitive behavioral therapy for insomnia) in real-world practice can feel daunting, especially when you’re not a sleep specialist.
I remember my first time recommending “sleep restriction” to a patient.
The look of panic on her face made me question if I was helping or just adding to their anxiety.
In fact, sleep restriction is often the thing that scares people away from CBT-i or leads to non-adherence with treatment.
This is where the art of clinical practice comes in: meeting patients where they are.
This week, I sat down with Dr. Parky Lau PhD, a sleep psychologist at Stanford, to talk about how to make CBT-I practical, flexible, and patient-centered, even for clinicians who don’t do this every day.
In this episode, Dr. Lau shares:
- How to build a case formulation for insomnia (and why it matters)
- How to practically implement time in bed restriction (and why he prefers that term over “sleep restriction”)
- Practical analogies (like pizza dough and finger trap) to help patients understand sleep
- How to adapt CBT-I for menopause and bipolar disorder
- Tips for supporting patients who are anxious, perfectionistic, or dependent on sleep aids
- How to build flexibility and empathy into a successful treatment plan
- And more…
When your next patient mentions insomnia, you’ll have practical tools from this video to guide your clinical thinking.
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References:
Walker J, Muench A, Perlis ML, Vargas I. Cognitive Behavioral Therapy for Insomnia (CBT-I): A Primer. Klin Spec Psihol. 2022;11(2):123-137. doi: 10.17759/cpse.2022110208. PMID: 36908717; PMCID: PMC10002474.
