#121 – A Practical Guide To Insomnia

Matt delves into insomnia, defining it as a persistent struggle to sleep despite having the opportunity. He presents "Cognitive Behavioral Therapy for Insomnia" (CBTI) as the scientifically validated gold standard, and details the five pillars: stimulus control to rebuild the bed-sleep association, time-in-bed restriction to boost efficiency, sleep hygiene, cognitive restructuring, and relaxation. These strategies retrain the brain to treat the bed as a sanctuary, deactivating the psychological triggers of wakefulness.

The episode also addresses the physiological impacts of caffeine, alcohol, and nighttime rumination. Walker contrasts traditional "Z-drugs," which may hinder glymphatic housekeeping, with newer "DORAs" that target the orexin system like a dimmer switch. While discussing tools like Trazodone, he emphasizes that CBTI’s aim is to restore the body’s innate sleep signals. These evidence-based interventions offer a lasting payoff by aligning behavior with our deep biological needs.

Please note that Matt is not a medical doctor, and none of the content in this podcast should be considered medical advice in any way, shape, or form, nor prescriptive in any way.

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As always, if you have thoughts or feedback you’d like to share, please reach out to Matt:

Matt: Instagram @drmattwalker, X @sleepdiplomat, 

YouTube: https://www.youtube.com/channel/UCA3FB1fOtY4Vd8yqLaUvolg