My guest this week is psychiatrist Dr. Jennifer Reid. We focused on how to fix insomnia, which Jenna and I both treat in our clinical practices. I’ve also been through years of poor sleep due to my health struggles, so I know firsthand what a drag it is when you just want to sleep but aren’t able to. Jenna and I discussed the best ways to get good sleep, and the downsides of many of the common sleep medications. The great news is that most people get a lot of benefit pretty quickly from a sleep treatment called Cognitive Behavioral Therapy for Insomnia (CBT-I), which we discuss at length. I hope you get a lot out of this discussion, and that it helps you to start sleeping better if you’re dealing with insomnia.

Topics we considered together included:

• How my guest and I slept the night before
• What insomnia is and how it’s different from sleep deprivation
• Why sleep problems are so prevalent
• The effects of stress, caffeine, medications, and anxiety on sleep
• Treating insomnia without medication
• Cognitive behavioral therapy for insomnia (CBT-I) as the first recommended treatment in professional guidelines
• The difference between natural sleep and medication-induced sleep
• The two drives for sleep: circadian rhythm and sleep hunger
• The effect of alcohol on inhibiting deep, restorative sleep
• The downsides of benzodiazepines (e.g., Xanax, Klonopin) for sleep
• Why sleep scheduling works and how it affects our sleep drives
• Training the brain that bed is for sleep, vs. worrying or feeling anxious
• Stimulus control, i.e., reserving the bed only for sleep (and sex)
• Setting realistic expectations for insomnia treatment
• Letting go of effort and trying hard to make oneself fall asleep
• Decreasing the fear of poor sleep
• How to wind down for a better night’s sleep
• Medications that Jenna sometimes prescribes for insomnia
• Difficulties and risks of coming off a sleep medication
• The confidence of taking a pill to sleep that can produce a placebo effect
• Over-the-counter sleep aids for insomnia
• How to start sleeping better starting tonight
• Transforming “what-if” worries about sleep into “if-then” statements

Jennifer Reid, MD, is a board-certified psychiatrist and award-winning medical educator, caring for patients in the Philadelphia area in her private practice and teaching residents as a clinical faculty member at the University of Pennsylvania.

Jenna attended medical school at Columbia University and completed her psychiatry residency at UCLA.

She is a regular contributor to Psychology Today on her blog, “Think Like a Shrink.”

She also writes and podcasts as The Reflective Doc, sharing information about the diagnosis and treatment of mental illness.

Find Jenna online at her website, Twitter, and Instagram, and check out her podcast.