CBT-I is a structured, short-term therapy recommended by sleep guidelines as the first treatment for chronic insomnia.
It targets the habits and worries that keep insomnia going, and its benefits usually last after therapy ends.
Key concepts
- Usually 4–8 weekly sessions, online or in person
- A sleep diary guides every step
- Sleep often gets slightly worse in week one before improving
Symptoms and signs
- Difficulty falling or staying asleep at least three nights a week
- Racing thoughts and clock-watching at night
- Fear of not sleeping that builds through the evening
Causes
- Spending long hours awake in bed
- Unhelpful beliefs such as 'I must get eight hours or I will fall ill'
- Stress that started the problem and habits that kept it going
Risk factors
- Anxiety or depression
- Long-term use of sleeping pills
- Chronic pain or medical illness
Evidence-based management
- Stimulus control: bed only for sleep, get up if awake
- Sleep restriction: time in bed matched to actual sleep, then widened
- Cognitive work on sleep worries
- Relaxation and wind-down skills
When to seek professional help
- Sleep problems lasting more than three months despite good habits
- Dependence on sleeping pills you want to reduce
- Insomnia along with low mood or anxiety
Frequently asked questions
Can CBT-I be done online?
Yes. Online CBT-I with a sleep diary works well for most people.
Do I have to stop my sleeping pills first?
No. Medicines can be reduced gradually during CBT-I under your doctor's guidance; never stop suddenly.
Medical references
Guidelines and official sources used for this article.
- Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 2021.
- ICD-11 for Mortality and Morbidity Statistics. World Health Organization.
- Author
- Dr. Kuldeep Budania, MBBS, MD Psychiatry
- Medical reviewer
- Dr. Kuldeep Budania, MD Psychiatry
- Last reviewed
This article is for general information and is not a substitute for personal medical advice.
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