Natalie Nevares spent three years in a stupor, sleeping just eight hours a week. Try as she might, the 45-year-old, who lives in Brooklyn, couldn’t fall or stay asleep. “You feel like you’re losing your mind,” she tells The Post.
For Kim Cattrall, who opened up about her long-running battle with chronic insomnia in an interview in early June, the sleep disorder was a “tsunami.” In 2015, Cattrall’s insomnia was so crippling that she dropped out of the musical she was starring in at the time, angering fans.
“It was a gorilla sitting on my chest,” Cattrall, 59, told Britain’s RadioTimes. “I didn’t understand the debilitating consequence of having no sleep.”
It’s a feeling to which the roughly 50 million to 70 million Americans suffering from chronic insomnia can relate. Despite the prevalence of the condition, characterized by trouble falling asleep, staying asleep and feeling rested, effective treatment is still elusive and can even be downright dangerous — from Ambien-induced sleep-eating sessions to car crashes caused by groggy, drugged-up drivers.
And while newer, safer medications show short-term promise, a long-term, drug-free treatment called cognitive behavioral therapy for insomnia, or CBT-I, is getting a seal of approval from the medical community.
The same treatment Cattrall credits with finally providing some relief, CBT-I typically runs between six and eight sessions over the course of four or five months, during which a sleep therapist will help identify behavior that prevents falling and staying asleep and work to change it.
“Medications are a Band-Aid, whereas CBT-I tries to teach people what sleep really is, [and] what are the things that prevent us from sleeping,” Dr. Jeremy Weingarten, director of the Center for Sleep Disorders at New York Methodist Hospital, tells The Post. It’s then on the patient to carry out the changes CBT-I suggests, which can include creating a technology-free resting space and getting out of bed after 20 minutes if you’ve yet to enter dreamland.
Although CBT-I has been a treatment for the past two decades, recent research is revealing just how effective it really is, and it’s finally gaining street cred with docs. A 2015 report in Annals of Internal Medicine found that CBT-I is an effective treatment for insomnia, improving sleep time, onset and efficiency with no adverse outcomes, while a University of Pennsylvania study published last week shows that getting out of bed when insomnia hits, as CBT-I suggests, can help sufferers get better shut-eye.
And in May, the American College of Physicians announced that CBT-I should be the initial treatment for insomnia before prescribing pills or trying over-the-counter sleep aids. “Many [doctors] believe that [CBT-I is] the only treatment that should be offered, but it’s very effort-dependent on the patient,” Weingarten says.
It’s also dependent on the practitioner. Regular CBT — practiced by a therapist to treat mental illness — may alleviate some of the stressors, but for a cure, it’s worth seeking out a sleep therapist trained in CBT-I. (Many are covered by insurance and listed in a database at SleepFoundation.org.)
‘Medications are a Band-Aid, whereas CBT-I tries to teach people what sleep really is.’
- Dr. Jeremy Weingarten
For others, getting to the root of the problem may take a different path. That was the case for Nevares, who now works to help sleep-train new families through her Manhattan-based business, Mommywise, by implementing changes similar to those promoted in CBT-I.
“I kept thinking, ‘If I could only get a good night’s sleep, I would feel better,’” she says, but at one point, “I was in the bathroom thinking, ‘My kids would be better off without me.’” It wasn’t until she visited a psychiatrist that she realized she had major depression. Just days after taking her first antidepressant, she was sleeping through the night.
Now she devotes her time to helping others beat insomnia. “[Sleep deprivation] is a torture method used around the world,” she says. “I know what that feels like, and it’s my mission to help parents diagnose and beat it.”
Tricks for hitting the hay
CBT-I is tailored to each patient, but the treatment promotes certain techniques that any insomniac can try.
• Ditch caffeine later in the day (4 p.m. is a good cutoff time), eating two hours before bed and drinking alcohol in excess. They can all keep your body from falling asleep, even if you’re mentally exhausted.
• Keep clocks out of view to nix the stress that comes when sleep doesn’t.
• Set a bedtime and wake-up time, and stick to them, even on weekends. Sleeping in on days off may feel good in the moment, but it can mess with your internal clock.
• Invest in blackout shades, better air conditioning and a sound machine — keeping your bedroom dark, cool (around 65 degrees) and free from street noise will help your brain tune out.
• Stop trying so hard. Just lying in bed, even if you’re not sleeping, will help you let go of stress.