Why You Can't Sleep and How CBT-I Fixes It with guest Dr. Jesse Spiegel

The Bonnies introduce Dr. Jesse Spiegel, a licensed clinical psychologist who treats children, adolescents, and adults. This episode focuses on insomnia and on cognitive behavioral therapy for insomnia, or CBTI, which they discuss as a first-line treatment.Dr. Jesse explains how insomnia is distinguished from short-term sleep problems. He describes chronic insomnia as difficulty falling asleep, staying asleep, or waking too early, occurring at least three nights a week for at least three months, with clear distress or impaired functioning.They discuss the main ideas behind CBTI and talk about sleep drive, circadian timing, and arousal, and how these factors interact with chronotype. Dr. Jesse notes that morning and evening types may have different sleep patterns, and we discuss that chronotype is largely biological.Dr. Jesse also covers the behavioral parts of treatment. He explains stimulus control, including going to bed only when sleepy, getting out of bed if unable to sleep, using the bed only for sleep and sex, waking at the same time each day, and avoiding naps when possible. He then describes sleep restriction, where time in bed is adjusted to better match actual sleep time in order to improve sleep efficiency.Finally, they talk about the thoughts and habits that can keep insomnia going. Also mentioned is worry, catastrophic thinking, safety behaviors, and the way sleep tracking devices can become unhelpful for some people. The goal with treatment is that it aims to reduce pressure around sleep and make it feel more effortless.HIGHLIGHTS:6:03 Meet Dr. Jesse Spiegel7:38 What Is CBT-I?12:02 Sleep Drive and Body Clock19:40 Bed Becomes a Battleground23:48 How CBTI Treats Insomnia30:09 The Core Sleep Debate34:20 Calming Sleep Anxiety39:10 Reframing Sleep Thoughts43:23 Wearables and Sleep Logsconnect with Dr. Jessewebsite: https://www.drjessespiegel.comCONNECT WITH THE BONNIE ZUCKERS:Bonnie Zucker Ph.D.(west)website: https://www.bonniezuckerphd.comNewsletter sign-up: https://bonnie-zucker-ph-d.kit.com/d44b57fcdfBooks by Bonnie West: https://a.co/d/04aNJFDZBonnie Zucker Psy.D. (east)website: https://www.bonniezuckerandassociates.comBooks by Bonnie East: https://shorturl.at/MxvRZThe content of Anxiety Matters Podcast is for informational purposes only and does not constitute mental health or medical advice, nor is it a substitute for professional mental health or medical advice, diagnosis, or treatment. If you are experiencing a mental health crisis, call emergency services or a local crisis line.