Still Awake at 2am? A BCBA’s Guide to Insomnia

As BCBAs, we pride ourselves on being focused, present, and effective for the families we serve. But when insomnia strikes—whether for a night, a week, or a whole season—it impacts everything:

• our ability to concentrate during session,

• our patience and emotional regulation,

• our creativity in solving complex behavior challenges, and

• our own health and immune functioning.

And we’re not alone. Research shows insomnia affects 10%–30% of the general population, and some studies estimate as high as 50%–60%, with women experiencing higher rates than men.

While insomnia often begins for an acute reason—stress, grief, illness, big life changes—chronic insomnia is typically maintained by a powerful, behavioral process:👉 the association between lying in bed and being awake.

In behavior-analytic terms, the bed becomes an SD for arousal, thinking, worrying, planning, scrolling, or anything other than sleep.

To break this cycle, we need to help the body relearn what the bed is for and we can use Acceptance and Commitment Training (ACT) and other behavioral strategies to get there.

Why ACT?

When we get hooked by thoughts like:

• “This is going to be a battle,”

• “I’m never going to fall asleep,”

• “Tomorrow is going to be a disaster,”

…our arousal rises, our cognitive fusion spikes, and sleep becomes even less likely.

ACT helps us notice these thoughts without engaging with them, accept the temporary discomfort of wakefulness, and redirect our behavior toward strategies that actually help sleep come naturally.

Try this instead: When thoughts come, pause, take a deep breath and change the channel. Something like “sleep isn’t coming to me right now and I can accept that”. When we unhook from negative thoughts, we can then move in alignment with our values by taking committed action towards strategies that will help with sleep in the long run.

Below are three behaviorally informed strategies you can use yourself—and teach to caregivers when appropriate.

1. Break the Bed-Wakefulness Association

If it’s been 20 minutes and you’re still awake, leave the bed.

This part can feel counterintuitive, but it is one of the most effective behavioral strategies for insomnia.

• Keep lights dim.

• Do something low-arousal (calm reading, quiet podcast).

• Return to bed only when sleepy.

• Repeat as needed.

Over time, this retrains the bed as an SD for sleep—not worry, stress, or wakefulness.

2. Stop Clock-Watching

Checking the time fuels anxiety (“Only 4 hours left… only 3…”).It can also condition future wakeups at that same time.

Turn the clock around, put your phone across the room, or remove visible time cues altogether.

3. Practice Mindfulness Instead of Mental Battles

Mindfulness is not about forcing sleep. It’s about reducing struggle so sleep can happen on its own.

Try:

• Box breathing

• Body scan meditation

• A “visual walk”: imagine walking a familiar route step-by-step, focusing on sensory details.

These exercises help the nervous system shift from activation to rest.

Check Your Sleep Hygiene

The next day, check the behavioral variables we know can sabotage sleep:

• Caffeine after early afternoon

• Bright light at night

• Email or social media in the bedroom

• Non-sleep behaviors in bed (work, eating, scrolling)

• Warm room temperatures

• Alcohol

• Late night meals

• Irregular sleep/wake times

When to Refer Out

If insomnia is persistent and interfering with functioning, CBT-I (Cognitive Behavioral Therapy for Insomnia) is the gold-standard treatment and requires a licensed mental health provider. We can support the process behaviorally, but we should collaborate and refer for ongoing insomnia.

Final Thoughts for BCBAs

We work in a field that demands emotional regulation, focus, compassion, problem-solving, and patience—all of which plummet with poor sleep.

Getting good sleep isn’t self-indulgent. It’s part of ethical practice. When we sleep better, we:

• show up more fully for caregivers,

• write better programs,

• think more clearly,

• maintain healthier boundaries, and

• model wellness for the families we teach.

  
  

Sleep is behavioral. Sleep is modifiable. And sleep is foundational for the work we do.