Psychology
Insomnia: causes, CBT-I and when sleeping pills help
Insomnia disorder means poor sleep at least three nights a week for three months, with daytime effects. CBT-I, not sleeping pills, is the first-line treatment.
27 Sept 20268 min read
CBT for insomnia
Also known as CBT-I, Cognitive behavioural therapy for insomnia, Cognitive behavioral therapy for insomnia
A short, structured therapy that retrains sleep habits and unhelpful thoughts about sleep. It is the recommended first treatment for long-term insomnia, ahead of sleeping pills.
In Psychology
CBT-I is a version of designed for long-term . A course often takes six to eight sessions, with a therapist or through a structured online programme, and it does not rely on medicine.
What it involves
- Stimulus control — using the bed for sleep, and getting up if you cannot sleep, so bed stops being linked with lying awake
- Sleep restriction — briefly limiting time in bed to the sleep you actually get, then widening it
- Cognitive work — tackling worries like "If I don't get eight hours I won't cope tomorrow"
- Relaxation and advice
Sleep restriction can leave you more tired for the first week or two before sleep improves. Unlike sleeping tablets such as , CBT-I carries no risk of dependence.
Where this comes up
Psychology
Types of talking therapy: CBT, DBT, EMDR and more
What CBT, DBT, ACT, EMDR, psychodynamic, interpersonal, family and group therapy involve, what each is best evidenced for, and how long each usually takes.
27 Sept 20267 min read
Related terms
- InsomniaSleeplessness, Chronic insomniaRegular difficulty falling asleep, staying asleep or waking too early, leaving you tired during the day. When it lasts three months or more it is called long-term insomnia.
- Sleep hygieneSleep habits, Good sleep habitsEveryday habits and bedroom conditions that support good sleep, such as regular times and less caffeine. Useful for everyone, but on its own it does not cure chronic insomnia.
- Cognitive behavioural therapyCBT, Cognitive behavioral therapyA structured, time-limited talking therapy that helps you notice and change the thoughts and behaviours that keep a problem going. It is a first-line treatment for depression and most anxiety problems.
- BenzodiazepineBenzos, BenzodiazepinesSedative medicines — such as alprazolam (Xanax), bromazepam (Lexotanil), clonazepam and diazepam — that quickly calm anxiety and aid sleep but are habit-forming. For short-term use only, under a doctor.