Frequently Asked Questions

CBTi stands for Cognitive Behavioural Therapy for Insomnia. It's a laser focussed approach to insomnia using cognitive and behavioural tools (but it is NOT the same as CBT, which is therapy and most CBT therapists are not trained in CBTi). These tools work on changing unhelpful behaviours and thoughts which are at the root of insomnia.

CBTi has been around for about 40 years and has lots of good quality research to show it works. So much so, that it is the recommended first-line approach to insomnia in the UK (NHS), USA & Canada (American College of Physicians, American Academy of Sleep Medicine & American Psychological Association) and Australia (Australasian Sleep Association, Royal Australian College of General Practitioners).

I know what you’re thinking.

Hang on a minute, if it’s effective & recommended by doctors in the UK, USA, Canada and Australia, why haven’t I heard of it before?!

That’s a really good question.

I’m based in the UK, and there are some NHS sleep services that offer CBTi, but very few. It’s just not widely available or known about, so GPs (Primary Care Physicians) struggle to refer patients if there’s no service in their area or very long waiting times. The sad reality is that many people that visit their GP in the UK with insomnia are likely to be sent home with a sheet of sleep hygiene tips and maybe a short course of sleeping pills.

What is CBTi?

During our work together, we would look together at what you think, what you do and how that effects to your sleep.

CBTi tools are an integral part of my Menoinsomnia® coaching programme (together with mindfulness, hypnotherapy and acceptance tools), which covers:

• learning about what you really need to get good sleep (and why what you’ve tried so far hasn’t worked);
• changing unhelpful behaviours around your bed, bedtime & sleep;
• adding new, helpful behaviours to your bedtime routine;
• working out how your thoughts and worries stop you sleeping;
• practicing ways to manage worries, anxiety and your racing mind; and
• learning how to deal with hot flushes/flashes and night sweats when they wake you.

How does CBTi work?

Studies have shown that CBTi has a very high success rate. The biggest reason for it not working is if you don’t complete the programme. CBTi tools are the foundation of my Menoinsomnia® coaching programme and I have built in other ways to support you.

These include: email check-ins between sessions, office hour access by email to have your questions answered (so you’re not left alone between our sessions), handouts to help you stay on track, plus confidence and energy boosting hypnosis tracks.

Will CBTi help my insomnia? 

A 2002 study showed that CBTi and sleeping pills produced similar short-term results in insomnia. And CBTi is a completely natural approach. Sleeping pills come with their own limitations (they sedate you, so the quality of sleep is not as good as normal sleep), risks (read the list of side effects) and IMPORTANTLY they don’t fix the underlying thoughts and behaviours that keep insomnia going as a chronic issue. They also interfere with your body's natural processes to bring on sleep.

What about in the long term?

In the long term, CBTi 'wins' over sleeping pills. Studies have shown that the sleep improvements made from CBTi continue on. In contrast, once you stop taking sleeping pills, the worries and behaviours that caused the insomnia are often still there. You may also suffer rebound insomnia, which happens when the sedating affect of certain sleeping pills wears off. Read more here and here.


Are Sleeping Pills Best For Insomnia?

Anyone over 18 years old who has been struggling with their sleep for over 2 months and
• has trouble going to sleep, staying asleep or waking too early;
• may be waking up in the night, possibly with hot flushes/flashes, night sweats or needing the loo;
• feel like they aren't getting good quality, restful sleep; and
• are generally in good physical and mental health (or have been advised by their GP or Primary Care Physician in writing that they can undertake CBTi).

Who is the Menoinsomnia® Programme for?

Anyone with any of the following conditions (including but not limited to):
• Any sleep disorder that is not insomnia such as restless leg syndrome (RLS), periodic limb movement disorder (PLMD), sleep apnoeas, narcolepsy, circadian rhythm disorders, idiopathic insomnia, paradoxical insomnia, parasomnias, night terrors, etc.
• Untreated obstructive sleep apnoea (if it’s being successfully treated, I may be able to help with written confirmation from your GP/Primary Care Physician)
• Any mental health condition which could potentially be worsened by the mild sleep restriction element of CBTi such as but not limited to PTSD, panic disorder, bipolar disorder, schizophrenia, psychosis, severe depression and anxiety
• Anyone currently or recently experiencing: suicidal ideation; acute mental health crisis; trauma; grief; or going through a big life event like moving house or job
• Any physical, mental or other condition that might be affected by restricted sleep for a period of time, for example, seizure disorders
• Pregnancy
• Anyone suffering from acute sleep loss requiring emergency help
• Anyone carrying out shift work
• Those not yet motivated to fix their insomnia

Important note: the CBTi approach may be, or may become, an option for those with the mental health conditions above with another provider. Please speak to your GP/Primary Care Physician together with your mental health professionals about this and they can advise you. I am not able to advise on the suitability of CBTi or the Menoinsomnia® coaching programme for any individual. 


Who is the Menoinsomnia® Programme not for?

Yes! We can discuss how you want to approach coaching. Any withdrawal from your sleeping pills would be under your doctor's direction and supervision but this can be done before, during or after coaching with me. 

I take sleeping pills, can I work with you?

I suffered from insomnia for years and after trying everything I could find that promised me better sleep, I eventually stumbled upon Cognitive Behavioural Therapy for Insomnia (CBTi). I'd never heard of it before! I was stunned to discover that CBTi is the recommended approach to insomnia by the NHS here in the UK (and it's recommended in the USA, Canada and Australia too). CBTi transformed my sleep for the better. I can still remember how euphoric I felt when I started to get good quality sleep at night.

Since then, I have qualified as a Cognitive Behavioural Hypnotherapist. Cognitive Behavioural Hypnotherapy (CBH) is an approach that combines cognitive behavioural therapies (CBT) & tools with mindfulness and hypnotherapy. It is an evidence-based approach (i.e. mainstream, peer reviewed evidence) built upon the large body of research backing CBT, mindfulness and hypnosis as psychotherapies that work.

It focuses on helping problems being experienced in the present day and also works on giving clients skills and knowledge to take away and use in future. So it's very much about building long-term self-empowerment.

Studies have shown that hypnosis can 'turbo-charge' the efficacy of cognitive behavioural therapies - so it is a powerful psychotherapy. A 2021 meta-analysis of the research around CBH found that hypnosis can make cognitive behavioural therapies work better and the results last longer. Read more here

My Diploma in Cognitive Behavioural Hypnotherapy was awarded by NCFE. NCFE is an independent, vocational awarding body recognised by the UK government's Department for Education and regulated by Ofqual. The Diploma is accredited by the British Psychological Society (BPS), the National Council for Hypnotherapy, the General Hypnotherapy Register and the Register for Evidence-Based Hypnotherapy and Psychotherapy.

In addition, I have undertaken further trainings in Cognitive Behavioural Therapy for Insomnia (CBTi) and Cognitive Behavioural Hypnotherapy for Insomnia (and many other professional trainings). I am a mindfulness teacher, trained to deliver the gold-standard of mindfulness based interventions, the Mindfulness Based Stress Reduction (MBSR) course. I have also completed years of counselling skills training.

Prior to this I was a solicitor (attorney) for over 10 years, having trained & worked in the City of London at an International law firm.


What are your qualifications and experience?

N.I.C.E., CLINICAL KNOWLEDGE SUMMARY, TREATING LONGTERM INSOMNIA (2022)

"Offer cognitive behavioural therapy for insomnia
(CBT-I) as the first-line treatment for chronic insomnia in adults of any age."

What the NHS says about CBTi

Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians (2016)

"ACP recommends that all adult patients receive cognitive behavioral therapy for insomnia (CBT-I) as the initial treatment for chronic insomnia disorder." 

What the American College of Physicians (ACP) says about CBTi

Edinger, J.D. et al. (2001) Cognitive Behavioral Therapy for Treatment of Chronic Primary Insomnia: A Randomized Controlled Trial. Journal of the American Medical Association 285 (14):1856-64

Morin, C.M. et al. (1999) Behavioral and Pharmacological Therapies for Late-Life Insomnia: A Randomized Controlled Trial. Journal of the American Medical Association 281 (11):991-99

Ramondo N, Gignac GE, Pestell CF, Byrne SM. (2021) Clinical Hypnosis as an Adjunct to Cognitive Behavior Therapy: An Updated Meta-Analysis. Int J Clin Exp Hypn. Apr-Jun; 69(2):169-202

Smith, M. T., et al. (2002) Comparative Meta-Analysis of Pharmacotherapy and Behavior Therapy for Persistent Insomnia. American Journal of Psychiatry 159 (1): 5-11

References

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