Treating Insomnia in Psychosis
摘要
This chapter presents a comprehensive CBT protocol for treating insomnia within the context of psychotic disorders. It begins with the rationale for addressing sleep disturbance as an early-stage therapeutic priority, given its contribution to exacerbating hallucinations, delusions, affective instability, and cognitive impairment. Assessment tools such as the ISI, PSQI, and Epworth Sleepiness Scale are reviewed to establish baseline severity and track progress. The chapter then details core CBT-I components—including sleep hygiene, stimulus control, relaxation techniques, sleep restriction therapy, and cognitive restructuring—adapted for individuals with psychosis to ensure safety and feasibility. A full clinical vignette illustrates how these techniques can be sequenced to reduce insomnia, stabilize the patient, and create downstream improvement in global psychopathology.