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Sleep Issues and Insomnia

10/14/2025 | Dr. Laura

empty white and gray bed set
Photo by Quin Stevenson on Unsplash

Have you ever had a bad night of sleep? Just one of those nights where you toss and turn, or you wake up in the middle of the night and can’t get back to sleep? You might notice that the rest of your day is now a bit more difficult - you snap more often, you notice you’re more negative, you count your whole day as a loss. These nights happen to everyone, and for most, it’s resolved in a couple of weeks.

However, for some, this is a nightly experience. When this kind of sleep happens every night for at least 3 months, and when it starts to impact your daily life, we begin to consider insomnia as a diagnosis. Defined as a dissatisfaction with sleep quantity or quality, insomnia is associated with one (or more) of the following symptoms:

  1. Difficulty initiating sleep. (In children, this may manifest as difficulty initiating sleep without caregiver intervention.)
  2. Difficulty maintaining sleep, characterized by frequent awakenings or problems returning to sleep after awakenings. (In children, this may manifest as difficulty returning to sleep without caregiver intervention.)
  3. Early-morning awakening with inability to return to sleep.1

You may also notice you sleep better in locations other than your bed - a couch or recliner in another room, on vacations, or even staying over at a friend’s or relative’s home. This is an indication that stimulus control is needed, and is something therapists trained in Cognitive Behavioral Therapy for Insomnia (CBT-I) can provide.2 Luckily, here at HHAWC we offer CBT-I and have had extensive experience helping clients improve their sleep. From early awakenings, to laying in bed wishing you could fall asleep, we are here to help!

Suffering from re-occurring nightmares? The same dream over and over, or different nightmares that you just can’t seem to shake? Image Rehearsal Therapy (IRT) is an effective treatment to improve and reduce nightmares.34 We offer IRT as a treatment and we would be more than happy to answer any other questions you might have! Reach out today by using our website contact form, or give us a call at 856-431-3669.

Disclaimer: These posts are for informational purposes only and are not a substitute for professional mental health care. Viewing or interacting with this post does not constitute a therapeutic relationship.

Footnotes

  1. American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787 ↩

  2. Rossman J. Cognitive-Behavioral Therapy for Insomnia: An Effective and Underutilized Treatment for Insomnia. Am J Lifestyle Med. 2019;13(6):544-547. Published 2019 Aug 12. doi:10.1177/1559827619867677 ↩

  3. Nappi CM, Drummond SP, Thorp SR, McQuaid JR. Effectiveness of imagery rehearsal therapy for the treatment of combat-related nightmares in veterans. Behav Ther. 2010;41(2):237-244. doi:10.1016/j.beth.2009.03.003 ↩

  4. Aurora RN, Zak RS, Auerbach SH, et al. Best practice guide for the treatment of nightmare disorder in adults. J Clin Sleep Med. 2010;6(4):389-401. ↩

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