Cognitive behavioural therapy (CBT) for insomnia

Cognitive behavioural therapy for insomnia (CBT-I) stands out as one of the most effective non-pharmacological treatments for insomnia. Unlike traditional sleep hygiene practices, CBT-I takes into account the psychological factors contributing to sleep disturbances.


Cognitive behavioural therapy for insomnia (CBT-I) offers a comprehensive and evidence-based approach to treating insomnia by addressing underlying cognitive and behavioural factors. While similar to sleep hygiene in its goal of improving sleep, CBT-I distinguishes itself through its focus on cognitive restructuring, sleep restriction, and stimulus control.

Individuals undergoing CBT-I can expect to learn practical skills to challenge negative thought patterns, modify behaviours, and optimise their sleep environment. Accessing a therapist with specialised training in CBT-I is essential for maximizing treatment efficacy and achieving long-term success.

What is cognitive behavioural therapy for insomnia (CBT-I)?

CBT-I is a structured, evidence-based psychological intervention specifically designed to address insomnia by targeting maladaptive thought patterns and behaviours that perpetuate sleep difficulties. It operates on the principle that insomnia is often maintained by cognitive arousal and dysfunctional sleep-related behaviours rather than solely by physiological factors.

Key components of CBT-I

Cognitive restructuring: Learn to identify and challenge negative thoughts and beliefs about sleep, replacing them with more adaptive ones. This process aims to reduce anxiety and hyperarousal associated with bedtime.

Sleep restriction: Establish a strict sleep schedule, limiting time spent in bed to match their actual sleep duration. This technique helps consolidate sleep and strengthen the association between the bed and sleep.

Stimulus control: Guidance of how to use the bed only for sleep and sexual activity, avoiding stimulating activities such as watching TV or using electronic devices in bed. This fosters a strong association between the bed and sleepiness.

Relaxation techniques: Various relaxation methods, such as progressive muscle relaxation and deep breathing exercises, are taught to help patients unwind and prepare for sleep.

Sleep hygiene education: While not the primary focus, CBT-I may include guidance on optimising sleep environment and habits, such as maintaining a consistent sleep schedule and avoiding caffeine close to bedtime.

Differences between CBT-I and sleep hygiene

While both CBT-I and sleep hygiene aim to improve sleep, they differ in their approach and scope. Sleep hygiene primarily focuses on optimising environmental and behavioural factors that promote sleep, such as maintaining a comfortable sleep environment and establishing a consistent bedtime routine.

In contrast, CBT-I goes beyond surface-level recommendations by addressing the underlying cognitive and behavioural patterns contributing to insomnia. It offers structured techniques to challenge negative thought patterns, modify behaviours, and foster long-term improvements in sleep quality.

What to expect from CBT-I

Undergoing CBT-I typically participate in a series of structured sessions with a trained therapist, usually over the course of several weeks. During these sessions, you will learn and practice CBT-I techniques under the guidance of the therapist. Homework assignments are often assigned to reinforce skills learned in therapy and monitor progress. Over time, you will typically experience improvements in sleep quality, reduced sleep latency, and decreased night-time awakenings.

The importance of accessing a therapist with additional training in CBT-I

While many therapists may offer general CBT interventions, specialised training in CBT-I is crucial for effectively addressing insomnia. Therapists with expertise in CBT-I possess a nuanced understanding of the complexities of sleep disorders and are equipped with specific strategies to target insomnia symptoms. They can tailor treatment plans to individual needs, monitor progress effectively, and address any barriers or challenges that may arise during therapy. Accessing a therapist with additional training in CBT-I ensures that patients receive the highest quality of care and have the best chance of achieving sustained improvements in sleep.

Prioritising a good night's sleep isn't just about feeling refreshed in the morning—it's about investing in your overall well-being. Quality sleep is the cornerstone of physical health, mental resilience, and emotional equilibrium. When we consistently enjoy restorative sleep, we empower our bodies to heal, our minds to rejuvenate, and our spirits to thrive. So, embrace the journey toward better sleep habits with the support of  CBT-I for a truly restful night. Your well-being deserves it.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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St. Neots PE19 & Bedford MK40
Written by Donna West, MBACP (Accred)ACTO (Snr) Psychotherapist/Clinical supervisor
St. Neots PE19 & Bedford MK40

I have worked with an array of clients whom have accessed counselling for varying reasons that they feel are inhibiting them from living an authentic life. My role within the therapeutic relationship is to work alongside an individual to facilitate self-exploration and consider alternative routes that may lay before them.

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