Cognitive Behavioral Therapy for Insomnia (CBT-I) is a structured, evidence-based treatment specifically designed to address chronic insomnia. It focuses on challenging and changing thoughts and behaviors that cause or worsen sleep problems. CBT-I is widely regarded as a first-line treatment for chronic insomnia.

CBT-I focuses on two main components of insomnia:

Cognitive factors: maladaptive thoughts, worry patterns, etc.

Behavioral factors: sleep schedules, time in bed, bedtime routines, etc.

The CBT-I process is prescriptive. It can be impactful on functioning in the short-term, so it’s important to plan ahead with your psychologist to find a time that is minimally disruptive. The process is:

Sleep restriction - limiting the time you spend in bed, to increase sleep efficiency. The goal is to consolidate sleep and reduce wake time during the night.

Stimulus control - reducing the time in bed where you are awake. Limiting things like TV watching, reading, scrolling, etc. that you may do in bed with the goal of increasing the association of sleep and bed.

Cognitive restructuring - challenging unhelpful thoughts and beliefs about sleep.

Psychoeducation on sleep hygiene - teaches basic habits to support healthy sleep.

Relaxation techniques - techniques to help your body and mind relax and be prepared for sleep.

CBT-I is considered the first-line treatment for chronic insomnia by major medical organizations. CBT-I is found to be more helpful than medication for long-term sleep improvement.