If you're one of the 30% of adults living with insomnia, you're not alone. Although there are medications available as a treatment option, sleep experts say that a form of cognitive-behavioral therapy is a safer, more practical alternative.

Cognitive-behavioral therapy for insomnia (CBT-I) is a short, structured, and evidence-based approach to combating insomnia's frustrating symptoms.

How does CBT-I work?

CBT-I works to help those with poor sleep establish a healthy sleep pattern, by exploring the connection between thoughts, feelings, and behaviors, with insomnia symptoms. A person's thoughts and feelings about sleep are examined and tested for accuracy, while actions are reviewed to determine whether they promote sleep. 

Depending on each person's unique needs, the length of treatment varies. Typically, it takes about 6-8 to notice any significant changes but may be as short as two sessions.

CBT-I techniques

With a combination of traditional psychotherapy techniques and sleep science, CBT-I methods include the following:

Cognitive restructuring

Cognitive restructuring begins to break the unhelpful cycle by identifying and challenging the thoughts that contribute to insomnia, particularly those resulting in feelings of guilt or anxiety. These thoughts often grow into a frustrating, ongoing cycle that feels difficult to break. Once these thoughts are identified, they're challenged and altered with a trained provider's help, and you may be encouraged to practice these skills between sessions.

Stimulus control

A person struggling with insomnia tends to spend more time in bed feeling stressed and may ultimately dread being in their bedroom. Stimulus control works to improve sleep hygiene by limiting the amount of time spent in bed- so someone may be asked to get out of bed after 20 minutes or so and find an activity to do. The goal is to find something you can put down once you feel sleepy so you can go back to bed. 

Sleep restriction and compression

The longer you're awake, the more your need for sleep increases. This is also known as your "sleep drive," It works to establish a consistent sleep schedule by limiting the amount of time you spend in bed. It's typically not recommended for those with medical conditions that can worsen by losing sleep, such as bipolar disorder or seizures.

Relaxation training

To enhance the effectiveness of treatment, CBT-I therapists may also introduce a variety of relaxation techniques. These techniques aim to reduce racing or worrisome thoughts that someone has while lying in bed, which is the most effective when implemented into a person's established routine.

A few commonly taught techniques include:

  • Breathing exercises or meditation
  • Progressive muscle relaxation (PMR)
  • Establishing a wind-down period before bed


A core component of CBT-I is that clients learn the importance of sleep and maintain good sleep hygiene, which includes increasing the behaviors and practices that encourage sleep while working to eliminate those that don't. 

Other topics that may be covered include diet, exercise, and the environment have on quality sleep.

How effective is CBT-I?

CBT-I is an "evidence-based therapy," meaning that it's been shown to be useful in various clinical studies. Several decades of research have accumulated to show how CBT can teach individuals how to fall asleep faster, stay asleep, and feel rested throughout the day. 

While this treatment has been incredibly effective in treating insomnia, the results aren't always immediate. It takes time to acquire and practice the skills learned in therapy. 


Insomnia is a common condition that can be treated effectively with CBT-I. Working with a trained professional can help prepare the mind and body for sleep, ultimately allowing you to improve the quality and quantity of sleep.