CBT-I Almost Killed My Aunt. Here's What I Learned About Sleep.

I became a sleep coach because a sleep program almost killed my very dear aunt.

Her insomnia started after she married off her last child. What should have been a wonderful new chapter in her life became the beginning of years of sleepless nights.

It would take her hours and hours to fall asleep. Some nights, she didn't sleep at all.

Once a week, usually after Shabbos, she would treat herself to a sleeping pill. The rest of the week, she muddled through, she's a trooper. She worked, took care of her family, and somehow kept going. She tried everything. Different mattresses, blinds, lavender, supplements, exercise, changing what she ate. You name it.

Nothing seemed to make much difference.

When a Sleep Program Became Another Struggle

Then one day, she came across an article about a sleep app based on Cognitive Behavioral Therapy for Insomnia, commonly known as CBT-I.

For the first week, she had to record when she fell asleep and when she woke up. At the end of the week, the app gave her a number.

27%.

Imagine struggling with sleep for years, trying everything you possibly can, and then seeing a number like that.

That percentage was likely measuring her sleep efficiency, which compares time asleep with time spent in bed. It's a useful measurement in sleep treatment, but when you're already exhausted and desperate, seeing such a low number can feel like another failure.

Based on her sleep data, the app gave her a schedule for the following week.

Bedtime: 2:30 a.m.

Wake-up: 7 a.m.

No exceptions.

She was exhausted beyond words. She would come home from work at five o'clock, barely able to function, knowing she had another nine and a half hours before she was allowed to go to bed.

She became so sleep-deprived that she was afraid to drive.

And she did this night after night.

At the end of each week, she entered her numbers, received another percentage, and was given another schedule.

There was no one to speak to. No one to ask whether what she was experiencing was normal, whether something needed adjusting, or whether she should even continue.

Just her, the computer, and the rules.

She did this for three months.

And here's the part I don't want to leave out.

Her sleep improved. It really did.

Today, almost ten years later, she's doing well. She's made many changes along the way. But she still describes those three months as one of the hardest experiences of her life.

I believe her.

Does CBT-I Actually Work for Insomnia?

Yes. CBT-I is an evidence-based treatment for chronic insomnia, and it can be extremely effective. It addresses behaviors and thought patterns that can interfere with sleep.

Strategies may include establishing a more consistent wake-up time, reducing excessive time spent awake in bed, and changing the way someone responds to sleeplessness.

These are valuable tools, and I use certain aspects of CBT-I in my own coaching.

But here's something I think we need to talk about more.

A person struggling with insomnia is so much more than her sleep schedule.

And although CBT-I includes cognitive and behavioral components, it can sometimes be presented or delivered as a set of rigid instructions, especially through automated programs.

I've written before about how easily helpful sleep advice can turn into rules that create even more anxiety. If this sounds familiar, you might enjoy reading my blog, Why “Am I Allowed to Sleep?” – The Surprising Sleep Questions I Heard at Chazkeinu.

My aunt's experience is a perfect example.

Her sleep improved, but what was happening to her emotionally and physically throughout those three months?

Who was checking whether she could function safely during the day?

Who was listening when she was struggling?

Why I Look at the Whole Person When Treating Insomnia

When someone comes to me struggling with sleep, I don't begin by handing her a list of rules.

I want to understand her.

What does her day look like? What happens when she gets into bed? Is she anxious about another sleepless night? Is she navigating hormonal changes? Is there emotional stress she's carrying around? Are there medical issues, medications, or other physical factors that need attention?

Sometimes the problem is largely behavioral. Perhaps she's spending far too many hours in bed trying to make up for lost sleep. In that case, changing those habits may be an important part of helping her.

But sometimes those behaviors are only one piece of a much bigger puzzle.

That's where my integrative approach comes in.

I may use behavioral strategies from CBT-I. I may work with anxious thoughts, acceptance, breathing, nervous system regulation, or other appropriate approaches.

When something suggests an underlying medical issue, I encourage further evaluation.

There's no single method that every person needs.

And sometimes the most important thing I can offer is the space for someone to tell me what's really happening, without feeling that she's failing because she hasn't followed a rule perfectly.

Better Sleep Is About More Than Following Rules

My aunt's experience taught me something I've never forgotten.

A treatment can work and still be incredibly difficult for the person going through it.

And when someone is experiencing extreme daytime sleepiness or feels unsafe driving, that isn't something to simply push through. It's a reason to reassess the treatment with a qualified professional.

I don't believe we need to throw away effective sleep strategies. Quite the opposite. I believe we need to use them thoughtfully, with flexibility, support, and an understanding of the individual.

Because sometimes we need to change behaviors. Sometimes we need to address what's happening beneath those behaviors. And very often, we need to do both.

That's why I became an integrative sleep coach. I wanted to understand the whole person, not just the hours she spends in bed.

That's still how I approach every person I work with.

Are You Struggling With Insomnia?

If you've tried sleep schedules, supplements, bedtime routines, and just about everything else, but you're still lying awake wondering what you're doing wrong, perhaps it's time to look beyond the rules.

I'd love to help you understand what may actually be keeping you awake and explore a way forward that makes sense for you.

Book a complimentary clarity call and let's talk about your sleep.