#341 - Overcoming insomnia: improving sleep hygiene and treating disordered sleep with cognitive behavioral therapy for insomnia | Ashley Mason, Ph.D.

Cognitive Behavioral Therapy for Insomnia (CBT-I) offers a highly effective, non-pharmacological framework for treating chronic sleep disorders by targeting the behaviors that perpetuate insomnia rather than solely focusing on its origins. Dr. Ashley Mason, an associate professor at UCSF, outlines the core pillars of this approach: stimulus control, which restricts the bed to sleep and intimacy, and time-in-bed restriction, which aligns sleep opportunity with actual sleep capacity. Managing racing thoughts through techniques like "scheduled worry time" and optimizing the sleep environment—specifically through temperature regulation and avoiding blue light—further supports sleep onset. Because insomnia is often maintained by inconsistent habits, establishing a fixed daily wake-up time is essential for recalibrating circadian rhythms. When followed with strict adherence, these behavioral interventions provide significant clinical improvement for the majority of patients, offering a sustainable alternative to long-term medication use.