If you’ve experienced life with insomnia, you know that it’s downright exhausting—in more ways than one. But finding the right insomnia treatment can be difficult, and many people struggle to know where to turn when standard sleep hygiene hacks aren’t cutting it.

Cognitive Behavioral Therapy for Insomnia (CBT-I) is one of the best ways to treat insomnia. But many people have never heard of it, and certainly don’t know how it works.

Craving a better night’s sleep? Keep reading to learn more about CBT-I and how it can help.

What Is Insomnia?

Insomnia is a common sleep disorder that affects 25 to 30 million Americans. People struggling with insomnia may have trouble falling or staying asleep, or may wake up too early and be unable to fall back asleep. Additionally, people with insomnia often still feel tired upon waking up, never feeling fully rested.

Sleep is one of the biggest factors impacting overall health, so insomnia can take a real toll on the body, affecting your health and ability to go about your day. It also can impact your mood, leaving you irritable or more emotional due to sheer exhaustion.

Short-term insomnia (insomnia lasting for a few days or weeks) is common, and affects roughly one-third of Americans over the course of their lives. However, chronic insomnia, which is defined as insomnia lasting three months or more, is a more serious concern, and many people are unsure about the best treatment method to pursue.

A woman sits up in bed, staring at her alarm clock, unable to sleep.

What Is CBT-I?

Cognitive Behavioral Therapy for Insomnia (CBT-I) is a structured psychotherapy model recommended as the first-line, gold-standard treatment for chronic insomnia that exists without an underlying medical condition. It is an evidence-based treatment method similar to standard Cognitive Behavioral Therapy (CBT), which is used to treat mental health conditions such as anxiety or depression.

How Does CBT-I Work?

Cognitive Behavioral Therapy is all about structure, and CBT-I is no different. When patients undergo CBT-I, they work through a disciplined program that works to help the body and brain relax and relearn how to sleep.

Typically, CBT-I is a brief therapy that can resolve sleep issues in 4-8 sessions, though this varies based on a patient’s therapist and treatment plan.

CBT-I works through a variety of different techniques:

Planning and Tracking

When beginning CBT-I, your therapist will help you develop a sleep plan that aligns with your lifestyle, such as ensuring you’re able to wake up each day at the proper time to meet your responsibilities. Patients are encouraged to track their sleep via a sleep diary throughout the process to see their patterns and progress.

Cognitive Restructuring

Many patients with insomnia have inaccurate or dysfunctional thoughts about sleep due to their extensive struggle or inability to sleep. CBT-I works to shift inaccurate thoughts or beliefs about sleep that may feel like a fixed mindset.

For example, many patients with insomnia have significant anxiety about sleep because it’s so difficult for them to fall or stay asleep. This can cause excessive worry each night, and may cause the patient to spend an irrational amount of time in bed, hoping that if they try hard enough or lay in bed long enough, they’ll have to fall asleep eventually. Often, this anxiety makes it even more difficult for the patient to sleep.

Stimulus Control

Stimulus control helps retrain the brain to form healthy associations between certain cues and either wakefulness or sleep. For example, your bed and a dark room should become strong cues for sleep, while activities associated with being awake—such as watching television or working on a laptop—should be kept separate from the sleep environment whenever possible.

When undergoing CBT-I, stimulus control methods can include:

Sitting or laying in your bed only when you intend to sleep
Keeping blue light devices out of your bedroom
Getting out of bed if you can’t sleep for more than 20 minutes
Keeping your bedroom dim or lit by a lamp after a certain point in the evening

Patients also work during the CBT-I treatment process to integrate different rhythms into everyday life, including using an alarm clock, staying active before bed, and incorporating accountability from friends and family.

Sleep Restriction

The goal for patients with CBT-I is to only spend the amount of time in bed needed to sleep. Laying in bed frequently is a temptation for patients with insomnia, as they hope to squeeze in some extra sleep in order to reduce daytime fatigue, but it rarely works and tends to make patients more tired.

Patients with insomnia also may try to nap throughout the day to make up for lost sleep the night before, but this also tends to interfere with nightly sleep.

The goal through CBT-I is to realign the amount of time spent in bed with the amount of time asleep. This happens via temporarily reducing the amount of time spent in bed, gradually increasing as you begin to sleep more consistently and are able to improve the depth of your sleep.

Relaxation Techniques

While relaxation techniques can be useful for anyone attempting to fall asleep more quickly, they’re especially crucial for patients with insomnia. A few common techniques integrated in CBT-I include:

Breathing exercises – Breathing exercises slow a patient’s heart rate, reducing anxiety and other mental struggles.
Meditation – Meditation can have a number of different mental health benefits, including reduced stress and increased presence. It can also promote relaxation for patients attempting to sleep.
Progressive muscle relaxation (PMR) – PMR involves consciously tensing and relaxing muscles to help the body physically relax.
Autogenic training – Autogenic training is a mindfulness technique that shifts your awareness to different parts of the body, increasing the mind-body connection and promoting relaxation.

Why Is CBT-I Effective In Treating Insomnia?

CBT-I is clear, practical, and hands-on. Your therapist will provide you with straightforward instructions, and all you have to do is follow your individualized plan. Patients who follow the steps as instructed by their therapist should see a tangible difference in their sleep habits and quality.

One of the best things about CBT-I is that patients learn why it works as they go through the process. In learning the science behind your sleep habits, you’re empowered to take your sleep into your own hands, feeling confident in your ability to go back to basics and establish a new baseline of sleep—without the help of medication.

Experience the Bliss of a Good Night’s Sleep With Expert Treatment at Aspire Psychology

If you’re struggling to sleep, you know that the ability to rest and recoup from the day is worth its weight in gold. At Aspire Psychology, we believe that you deserve to sleep well every night—and we’re here to help you get there.

Contact us today to learn how CBT-I can help you get a better night’s sleep.

What Is CBT for Insomnia (CBT-I)?: The Gold Standard for Getting a Good Night’s Sleep