Cognitive Behavioral Model Of Insomnia (Harvey, 2002)

Insomnia is one of the most prevalent sleep disorders, affecting around 10% of the population. There is a sound evidence base showing that it is an exacerbating factor many in psychological disorders, and it is frequently reported by people struggling with anxiety and depression (although it is not a primary symptom). It has further been established that problems with sleep precede – and may contribute to – the development of depression (Harvey, 2001). Even without knowing the direction of causality, there is a strong relationship between insomnia and psychological disorders. Co-morbidity with other mental health conditions is high, and it is listed as a symptom across a wide range of other sleep, mood, neurological and mental health disorders: “insomnia as a symptom of psychological disorder is 10 times more frequent than insomnia related to a physical illness” (Ford & Kamerow, 1989; Harvey 2001). Chronically poor sleep has a significant

• Client handout – use as a psychoeducation resource
• Discussion point – use to provoke a discussion and explore client beliefs
• Therapist learning tool – improve your familiarity with a psychological construct
• Teaching resource – use as a learning tool during training

• Ford, D. E., & Kamerow, D. B. (1989). Epidemiologic study of sleep disturbances and psychiatric disorders: an opportunity for prevention?. Jama, 262(11), 1479-1484.
• Freeman, D., Sheaves, B., Goodwin, G.M., Yu, L.M., Nickless, A., Harrison, P.J., Emsley, R., Luik, A.I., Foster, R.G., Wadekar, V. and Hinds, C., (2017). The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis. The Lancet Psychiatry, 4(10), pp. 749-758.
• Harvey, A. G. (2001). Insomnia: Symptom or diagnosis? Clinical Psychology Review, 21, 1037–1059.
• Harvey, A. G. (2002). A cognitive model of insomnia. Behaviour Research and Therapy, 40, 869–893.
• Harvey, A.G. (2005) A Cognitive Theory and Therapy for Chronic Insomnia. Journal of Cognitive Psychotherapy: An International Quarterly, 19(1), p.41-59.
• Harvey, A.G., Soehner, A.M., Kaplan, K.A., Hein, K., Lee, J., Kanady, J., Li, D., Rabe-Hesketh, S., Ketter, T.A., Neylan, T.C. and Buysse, D.J., (2015). Treating insomnia improves mood state, sleep, and functioning