Cognitive Behavioral Therapy for Insomnia (CBT-I)

What is CBT-I?

CBT-I is an evidence based cognitive-behavioral therapy treatment for people who are experiencing insomnia. It is considered to be the most effective therapy for insomnia, with some research showing that it is even more effective long-term than sleeping pills. CBT-I helps people change the behaviors that are interfering with their sleep. It also helps people identify and challenge the negative thoughts that make it more difficult to fall asleep.

What happens during CBT-I?

The behavioral part of CBT-I helps clients develop good sleep habits and avoid behaviors that keep them from sleeping well. Clients work with their therapist to set up a sleep schedule that will help their body clock get back on track with sleeping and awakening at the right times. They also make changes to improve their sleep hygiene so that they are creating the most beneficial sleeping environment. Some changes could be reducing the amount of noise and light in their bedroom or changing their caffeine, alcohol or other habits during the day. CBT-I also typically incorporates some relaxation training to help clients manage racing thoughts and make it easier to have a quieter mind at bedtime.

The cognitive part of CBT-I teaches clients to recognize and change beliefs that affect their ability to sleep. This type of therapy can help people control or eliminate negative thoughts and worries that keep them awake.
The therapist will help clients identify and challenge their thoughts that are making it harder for them to get to sleep. For example, someone having problems falling asleep might think, “If I don’t get to sleep in 15 minutes, tomorrow is going to be ruined.” This thought puts a lot of pressure on falling asleep and increases the tension that this individual feels, making it less likely for this person to fall asleep. With CBT-I, this person would be encouraged to challenge this thought and replace it with a more accurate one, such as “I hope to fall asleep soon, but I will make it through the day tomorrow even if I don’t get a lot of sleep tonight.”

How long does treatment last?

CBT-I typically lasts for about 8-12 sessions.

Is homework a part of CBT-I?

Yes. CBT-I will not be effective if clients do not complete the homework assignments. Clients will be given homework to keep a sleep diary to track their sleep and activity patterns. They will also be making changes to some of the daily life activities that are interfering with their sleep. They will also complete worksheets to identify and challenge distorted thoughts. Most people also engage in some type of relaxation exercises as a part of CBT-I. Homework will typically take about 20-30 minutes each day.
CBT-I (Cognitive Behavioral Therapy for Insomnia) Online Resources

Conquering Insomnia
A self-paced CBT-I treatment program that guides you through the CBT-I steps on your own. Includes worksheets and relaxation exercises. Cost ranges from $50-$70.

Free CBT-I
A 30 day guide to help individuals implement CBT-I techniques. Can be used on your own or in conjunction with a therapist. This app includes sleep diaries, quizzes, and helpful handouts.

National Sleep Foundation
Provides information about sleep disorders and a variety of treatment options

American Academy of Sleep Medicine
Provides information about sleep disorders and a variety of treatment options

CBT-I Coach
Free app to use along with your CBT-I sessions. This app includes a sleep diary, reminders, relaxation exercises and additional CBT-I tools.

YouTube Video on CBT-I

Provides an overview of CBT-I