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Kimberly Schildbach Therapy - Insomnia Solutions

Online Insomnia Treatment for Clients in in Washington, Massachusetts, Connecticut, and Florida.

Therapy for Insomnia

CBT-I Therapy for Insomnia

CBT-I for Insomnia: The Gold-Standard Treatment That Actually Lasts

Online Therapy for Insomnia for clients in all of Massachusetts, Washington, Connecticut, and Florida.

If you’re struggling with insomnia, you already know this isn’t just about being “a bad sleeper.” Chronic insomnia affects how you think, feel, function, and move through your day. It touches your mood, your relationships, your health, and your ability to feel like yourself.

And here’s something important I want you to know right away: insomnia is a real, treatable condition - not simply a symptom to ignore or push through.

Research over the last two decades - including work highlighted by sleep experts like Dr. Michael Vitiello at University of Washington - consistently shows that Cognitive Behavioral Therapy for Insomnia (CBT-I) is the most effective first-line treatment for chronic insomnia. It’s considered the gold standard because it creates lasting change, not just temporary relief.

CBT-I for Insomnia Will Help You If…

You’ve been struggling with lack of sleep for 3 months or 30 years.

You’re in the midst of menopause, aging, or have been diagnosed with -  or are experiencing symptoms of - depression, anxiety, or PTSD.

Combined with CBT-N, it can also help if nightmares are disrupting your sleep, whether they come from a traumatic event or the source feels unclear.

You’re struggling to be present for family, work, or the life you want to be living.

You’re experiencing irritability, memory problems, or diminished decision-making.

It will especially help if you feel anxious about getting more sleep.

You’ve tried tools, apps, or other biohacking approaches but don’t know how to put them together into a sleep plan that actually works.

You have - or haven’t - found short-term relief with medications but either don’t want to continue them or want to avoid them altogether.

Insomnia and Mental Health: They’re Connected

Insomnia rarely lives in isolation. Many people I work with also struggle with anxiety, depression, chronic stress, or pain. The encouraging news is that when sleep improves through CBT-I, many people notice meaningful improvements in mood and emotional resilience as well - even when those issues aren’t directly targeted in treatment.

Better sleep often creates a stronger foundation for everything else.

A Session-to-Session Roadmap

Here you’ll find a clear outline of how the program unfolds and what each stage focuses on.
CBT-I for insomnia is structured, practical, and evidence-based - you won’t be left guessing. You’ll understand what we’re working on, why it matters, and how each step builds toward more consistent, restorative sleep.

And at the same time, reading about it is very different from experiencing it. The real shift happens when you begin applying the tools in your own life and we adjust them to fit you.

This approach has helped many people reclaim their sleep, and it may be the turning point you’ve been looking for.

Full Assessment During our sessions, I’ll ask you a series of questions based on the Structured Clinical Interview for Sleep Disorders, along with information from your intake forms and your own description of what you’ve been experiencing. We’ll explore your sleep patterns, any difficulties falling or staying asleep, nightmares, and the habits or routines that may be affecting your rest. From what you share, I’ll develop a treatment plan tailored specifically to you. My goal is to create a clear, practical approach that fits your life and addresses the root of what’s disrupting your sleep, not just the symptoms. If I need to refer you to you PC or a sleep clinic - this will be discussed during your assessment.

Understanding sleep Next session, we’ll cover the basics of how sleep works. I’ll explain sleep drive, sleep cycles, and how your brain and body work together to allow sleep — or sometimes interfere with it. We’ll also look at three factors that contribute to insomnia: predisposing factors (what may have made you vulnerable), precipitating factors (stressful or traumatic events that triggered it), and perpetuating factors (habits like studying in bed, napping, or sleeping in that unintentionally keep it going). Those perpetuating factors can be the hardest to shift, but they’re also where we tend to see the most progress once you understand what truly helps insomnia. We’ll begin tracking your sleep to see how much you’re getting right now, and using CBT-I, we’ll gradually adjust and expand your sleep window. As you learn how sleep drive works and how your brain and body operate together, sleep starts to feel less mysterious and less out of your control. That understanding alone often reduces anxiety — and creates momentum toward deeper, more consistent rest.

Sleep Schedule Next, we’ll focus on your sleep schedule and take a close look at how much time you’re spending awake and frustrated in bed - and how we can shift that. I’ll ask about what you use your bed for, how you unwind at night, whether you sleep in on weekends or after a rough night, if you stay in bed hoping sleep will eventually come, and whether you nap the next day. These patterns are completely understandable - and they’re often the very things that keep insomnia going. This is where the real behavioral work begins. It can be challenging for most people. But small, consistent changes in these habits give you the best possible opportunity for deeper, more consistent sleep. It may feel hard at times, especially when you’re tired. I’ll be there to guide you and remind you of the long-term goal: not just getting through one night, but building reliable, restorative sleep over time.

Sleep Hygiene As with every session, we’ll use data from your ongoing sleep log to guide our work. We’ll review your sleep hygiene and look at patterns that may be affecting your rest - for example, grabbing caffeine in the afternoon when your energy dips, or using alcohol to ease anxiety before bed. We’ll build on our previous sessions by carefully reviewing your log, including any notes about caffeine or alcohol use, so you can see what the data actually reveals about your sleep on those nights. Often, the patterns become clearer when we look at them objectively. If your sleep hygiene looks solid and you’re not reporting concerns, we’ll review your gains, look at the progress reflected in your data, and move forward to our next intervention: practical tools for stress management and relaxation - strategies that are evidence-based and designed to support the other skills you’re learning. The goal is for you to begin building a comprehensive, personalized plan for consistent, restorative sleep.

Body and Brain Based Relaxation Strategies By this point, you may already be noticing improvements in your sleep. If you’ve been following the program, you might find yourself going to bed feeling genuinely sleepy and waking less during the night. You’ve built a strong foundation - and now we expand it. In this phase, we focus on stress management and relaxation skills. We’ll build on techniques you already use and enjoy, or I’ll introduce new ones such as diaphragmatic breathing or guided body scanning. Stress and life events can certainly trigger sleep difficulties - but over time, sleep itself often becomes a source of anxiety. These skills are designed to interrupt that cycle. They help calm your nervous system before bed and give you tools you can use anytime during the day when stress rises. These techniques are skills that you'll get better at over time. We'll troubleshoot any problems and find solutions so relaxation skills become a part of everyday life.

Replace Alarming Thoughts In this phase, we’ll begin identifying and addressing common unhelpful or dysfunctional thoughts about sleep - and developing realistic, balanced alternatives. When sleep has been a struggle for a long time, or when traumatic nightmares are part of the picture, thoughts about sleep can become intense or even alarming. It’s common to hear things like, “I’ll never function tomorrow,” or “If I don’t sleep, something bad will happen.” These thoughts can activate your nervous system and make sleep even harder. Together, we’ll slow those thoughts down. We’ll look at each one carefully and generate more accurate, helpful cognitions that remind your brain and body that sleep is essential - and that there are practical, effective things you’re doing to support it. They don’t call it CBT for nothing. This skill doesn’t just improve sleep. It becomes a tool you can use at work or school, when anxiety spikes, or during stressful periods of life. Learning how to respond differently to intrusive or negative thoughts is powerful well beyond bedtime. Think of this as another layer in your overall sleep plan. Like building a great sandwich - each layer matters. When we stack behavioral changes, relaxation skills, and cognitive tools together, you create something solid, sustainable, and nourishing for the long run.

Breaking the Bedtime Thought Cycle At this stage, we focus on stress-related thoughts that show up before bed. These thoughts might be about work, school, family responsibilities - or about sleep itself: Will I get enough? How will I function tomorrow? What if this happens again? Whatever consistently happens in your bed eventually becomes associated with your bed. When worry, planning, or fear shows up night after night, your brain begins to link the bed with alertness instead of rest. That negative thought cycle can be difficult to interrupt. These racing or stressful thoughts create what we call cognitive arousal - a state of mental activation that often triggers emotional and physical arousal as well. Your heart rate may increase, muscles may tense, and your nervous system shifts into alert mode. All of this makes falling asleep much harder. In this session, we’ll work directly with that cycle. We’ll identify the patterns in your pre-sleep thinking, introduce strategies to contain or restructure those thoughts, and practice ways to reduce mental activation before bed. As always, we’ll continue reviewing your sleep diary data as we introduce new skills - troubleshooting challenges, reinforcing previous strategies, and reconnecting you with your larger goal: building consistent, restorative sleep over time.

Wrapping Up & Planning for Possible Relapses As we conclude your program, it’s important to recognize the progress you’ve made. Most clients who follow these strategies continue to enjoy consistent, restorative sleep for years - research shows** often a decade or more. At the same time, we plan for the possibility of relapses. Sleep disruptions can naturally return during times of stress or life transitions - a new job, a baby, moving to a new home - or if healthy sleep habits aren’t followed as closely as before. Often it’s a combination of factors, and that’s completely normal. The key is that now you have tools and a plan. A relapse isn’t a failure - it’s an opportunity to use the skills you’ve learned to regain control. If you find yourself stuck, a booster session can help: we’ll review your sleep, identify areas to implement your strategies, and get you back on track. You walk away with more than better sleep; you leave with a clear, practical plan for maintaining your gains long-term, along with the confidence that you can respond effectively if insomnia ever returns. **https://pubmed.ncbi.nlm.nih.gov/29753926/

Booster Sessions (optional) Booster sessions are short, focused check-ins designed to help you maintain your progress and address any challenges that come up after completing the core program. Think of them as a tune-up for your sleep plan. Even with consistent effort, life events, stress, or changes in routine can sometimes disrupt your sleep. A booster session gives us the chance to review your sleep diary, troubleshoot areas where your habits may have slipped, and reinforce the skills you’ve already learned. These sessions are not a sign of failure - they’re a proactive way to keep your sleep on track and prevent small disruptions from becoming bigger problems. With a booster session, you can regain control quickly and confidently, ensuring your long-term sleep health stays strong.

FAQs about CBT-I and Therapy for Insomnia

What is CBT-I and how is it different from regular therapy?

CBT-I (Cognitive Behavioral Therapy for Insomnia) is a structured, evidence-based treatment specifically designed to improve sleep. While traditional therapy may explore many parts of your life, CBT-I focuses directly on the thoughts, habits, and nervous system patterns that keep insomnia going - so you can build lasting, natural sleep changes. 

Is CBT-I really effective for chronic insomnia?

Yes. CBT‑I is considered the gold‑standard treatment for chronic insomnia because it helps you change the patterns causing sleep difficulties rather than simply masking symptoms. Most people see improvements in falling asleep, staying asleep, and feeling more rested — and research shows these changes tend to last long after treatment ends, with significant benefits maintained up to ten years after treatment. For example, a very long‑term follow‑up of a randomized controlled trial found that improvements in insomnia severity were still present at a ten‑year follow‑up, and about two‑thirds of participants no longer met criteria for insomnia at that point.

How long does CBT-I take?

This is the great part. CBT-I is short-term and targeted. Many people begin noticing changes within a few weeks, with treatment often lasting around 6–8 sessions depending on your history and goals.

Do I have to stop taking sleep medication?

CBT‑I is designed to improve sleep naturally, and it works whether or not you are taking medication. Some people begin CBT‑I while on medication and later choose to taper or discontinue it, while others pursue CBT‑I specifically to avoid medications. Research shows that CBT‑I is effective both for those continuing sleep medications and for those who gradually stop them, and combining CBT‑I with medication can also be beneficial for many patients. We work collaboratively at a pace that feels safe and realistic for you.

Can CBT-I help if I also have anxiety, depression, PTSD, or health concerns?

Absolutely. Insomnia often exists alongside conditions like anxiety, depression, post‑traumatic stress, chronic pain, and other health concerns, and research shows that treating sleep with CBT‑I can have positive effects beyond just sleep itself. For example, CBT‑I can improve insomnia symptoms in people with comorbid health conditions like chronic pain and is associated with reductions in depressive symptoms and fatigue. Studies also find that improving insomnia through CBT‑I is linked with better outcomes in anxiety, depression, and PTSD symptoms - not because it “fixes everything” at once, but because better sleep strengthens emotional resilience and makes other challenges feel more manageable. You don’t need to “fix everything else first” before working on your sleep - improving sleep can actually support improvements in mood and overall functioning.

What if I’ve already tried apps, supplements, or sleep hacks?

You’re not alone. Many people come in having tried tools, trackers, and biohacking strategies without lasting relief. CBT-I helps you integrate what actually works into a personalized, coherent sleep plan instead of chasing disconnected solutions.

Will CBT-I help if I’m anxious about sleep itself?

Yes - and this is one of the biggest reasons CBT-I works. When sleep becomes something you worry about or try hard to control, it often gets harder. CBT-I helps reduce sleep anxiety so your nervous system can relearn how to rest.

What is CBT-N and how does it help nightmares?

Most people with frequent nightmares also struggle with insomnia, so CBT-N (Cognitive Behavioral Therapy for Nightmares) is often combined with CBT-I. When used together, you gain the full set of skills to improve sleep and address distressing dreams.

CBT-N addresses factors like sleep anxiety, safety behaviors, and the desire to honor the message or loss contained in the nightmare. It uses practical interventions such as writing out the nightmare, rescripting it, and using Imagery Rehearsal Therapy (IRT) - a process where you learn to take back the story and change it with you in the driving seat. This gives your brain a new path to focus on instead of replaying the same distressing scene over and over.

CBT-N is effective for trauma- or PTSD-related nightmares as well as for nightmares with no clear origin. It’s a specialized treatment that can be added whenever nightmares are disrupting sleep, helping your nights become safer, more restful, and more restorative.

What if I’ve had insomnia for years?

CBT-I can still help. Whether you’ve struggled for a few months or for decades, your sleep system can change. Chronic insomnia is learned - which means new sleep patterns can be learned too.

Kimberly Schildbach Therapy - Insomnia Solutions

Schedule your first appointment. Reach out with questions. I'm looking forward to hearing from you.

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Offering evidence backed sleep solutions to clients in Massachusetts, Washington, Connecticut, and Florida.

Kimberly Schildbach Therapy operates on the unceded ancestral lands of the Nipmuc and Pocumtuc peoples. We honor their enduring presence and stewardship of this land.

I'm also a highly trained and experienced Emotionally Focused Couples Therapist and Certified Discernment Counselor. If you're looking for couples therapy please see my other website: Kimberly Schildbach Therapy.

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