Sleep & insomnia
Psychology for insomnia and sleep difficulties
Sleep difficulties can look different from person to person. You may find it hard to fall asleep, wake during the night and struggle to return to sleep, or wake earlier than you intended and find yourself unable to get back to sleep.
Over time, sleep can start taking up more mental space during the day. You might wonder whether tonight will be better, plan around how tired you expect to feel, or notice changes in your mood, concentration, energy or confidence.
It is understandable to seek support when sleep starts affecting your days as well as your nights. You do not need a diagnosis or a clear explanation before getting in touch. A description of what your sleep currently looks like is enough to start with.
Saturdays: In person in BlackburnWednesdays & Thursdays: Telehealth, including after hours
Particular clinical experience
Della is trained to deliver Cognitive Behavioural Therapy for Insomnia (CBT-I) and has clinical experience providing psychological treatment for insomnia within a specialist sleep clinic setting.
What this often looks like
- Lying awake for a long time before falling asleep
- Waking during the night and finding it difficult to return to sleep
- Waking earlier than intended and being unable to get back to sleep
- Thinking or worrying during the day about how you will sleep that night
- Becoming increasingly focused on sleep
- Feeling tired but finding that sleep still does not come easily
- Tiredness affecting mood, concentration, energy or confidence
- Changing plans or routines because of concern about sleep
What is CBT-I?
CBT-I stands for Cognitive Behavioural Therapy for Insomnia. It is a structured psychological treatment developed specifically for ongoing insomnia.
CBT-I looks at the thoughts, behaviours and sleep patterns that may be keeping insomnia going. It is more than general sleep hygiene or advice about having a good bedtime routine.
Depending on your sleep pattern and circumstances, CBT-I may involve:
- learning how sleep works
- keeping a sleep diary to understand sleep patterns
- changing habits or routines that may be interfering with sleep
- strengthening the connection between bed and sleep
- adjusting sleep timing or time in bed where appropriate
- working with worry, pressure and unhelpful beliefs about sleep
- practising strategies between sessions
Not every strategy is appropriate for every person. We first look at your sleep, health and circumstances before deciding what is likely to be useful. General information about CBT-I is available from the Sleep Health Foundation.
When sleep becomes part of the problem
When sleep becomes difficult, it makes sense to try to compensate. You might go to bed earlier, stay in bed longer to catch up, change your routines, cancel plans, or spend time trying to work out what went wrong the night before.
These responses are understandable. Some may provide relief in the moment. Over time, however, certain habits can unintentionally keep insomnia going. There may be more time spent awake in bed, more effort spent trying to make sleep happen, and more attention placed on sleep as something that needs to be controlled.
Part of the work is understanding which responses are useful for you and which may no longer be helping.
How psychological treatment may help
We start by getting a clear picture of your sleep pattern across several nights, alongside how those nights have felt. A sleep diary can sometimes help us understand what is actually happening across several nights.
From there, we look at what may be maintaining the insomnia for you. Treatment can involve practical changes to sleep habits and timing, working with anxiety and pressure around sleep, changing responses to periods of wakefulness, and looking at thoughts or behaviours that may be contributing.
I will explain what we are trying and why. Some CBT-I strategies can feel counterintuitive at first, so there is room to ask questions and understand the reasoning before making changes.
I do not provide sleep studies, prescribe or change medication, or provide medical sleep diagnoses. Where relevant, I am happy to work alongside your GP or treating doctor.
Is CBT-I just sleep hygiene?
No. Sleep hygiene refers to general habits that can support sleep, such as routines, caffeine use and the sleep environment. These things can be useful, but ongoing insomnia often requires more than general sleep advice.
CBT-I is a structured treatment that looks specifically at the patterns of thinking and behaviour that can maintain insomnia.
Sleep and anxiety can affect each other
Poor sleep can make worry harder to manage, while an active or worried mind can make it harder to settle at night. Where both are part of the picture, we can look at how sleep and anxiety interact.
Learn more about anxiety and overthinking
About the psychologist
Della Zhang is a Registered Psychologist working with adults in Melbourne and via Telehealth. She is trained to deliver Cognitive Behavioural Therapy for Insomnia (CBT-I) and has clinical experience providing psychological treatment for insomnia within a specialist sleep clinic setting.
Questions people often ask
- What is CBT-I?
- CBT-I is Cognitive Behavioural Therapy for Insomnia, a structured psychological treatment for ongoing insomnia. The section above explains what it can involve.
- Do I need a sleep study before seeing a psychologist?
- Not necessarily. Many people begin psychological treatment for insomnia without having a sleep study. If something in your history suggests that another sleep disorder may need assessment, I will raise this and suggest discussing it with your GP or treating doctor.
- What if I take sleeping medication?
- You can still seek psychological treatment while taking sleep medication. Decisions about starting, stopping or changing medication need to be made with your prescribing doctor. Psychological treatment can occur alongside those conversations.
- What if I also have sleep apnoea?
- Insomnia and sleep apnoea can occur together. Psychological treatment for insomnia may still be relevant, while continuing appropriate medical treatment for sleep apnoea remains important.
- When does poor sleep become insomnia?
- A few unsettled nights during a stressful period are different from an ongoing sleep problem. Insomnia involves repeated difficulty falling asleep, staying asleep or waking earlier than intended, together with an impact on daytime functioning. Assessment considers the pattern over time and not just one or two difficult nights.
- How long does CBT-I take?
- CBT-I is usually delivered as a relatively structured course of treatment with a defined focus. The number and spacing of sessions can vary depending on your sleep difficulties, health, progress and circumstances. We can discuss what is appropriate after understanding your sleep pattern.
- What happens at the first sleep psychology appointment?
- The first appointment focuses on understanding your current sleep pattern, how the problem developed, what you have already tried, relevant physical and mental health factors, and what you would like to change. We can then discuss whether psychological treatment for insomnia is likely to be useful and what the next steps may involve.
This information is general and does not replace individual medical or psychological advice.
In person appointments are available in Blackburn on Saturdays, with Telehealth also offered on Wednesdays and Thursdays, including after hours.
Thinking about making an appointment?
You don’t need to have everything figured out before reaching out. Tell me a little about what you’re looking for and I’ll contact you about the next step.
Want to talk first? You are welcome to to ask a couple of questions.