Cognitive Behavioral Therapy for Insomnia

The Underused, But Recommended Treatment

By Dr. Dan Gartenberg

Last Updated: March 30, 2023


Did you know that the recommended first-line treatment for insomnia is usually not a pill, but 6-10 weeks of cognitive behavioral therapy for insomnia (CBTi). CBTi is usually administered by a trained therapist, please consult your clinician if you think you could benefit from CBTi. CBTi works by addressing insomnia at its root, by changing your habits, thoughts, and behaviors around sleep. By addressing patterns that cause sleep disruptions, the treatment is designed to promote sleep health and consolidate sleep. Recent evidence has shown that electronic web-based CBT can be beneficial, but human-to-human treatment is still our best way of addressing this very common problem that impacts 30-50 million Americans every year.

The solutions outlined below may be more or less relevant to your particular sleep need. Simply being aware of the below rules and methods for promoting healthy sleep can give you the tools you’ll on addressing your sleep conquering and sleeping your personal best.

Our grant funded research with the National Institute of Aging is designed to demonstrate that we can use technology to finally improve sleep when working alongside a clinician. Technology can now be used for getting a deeper night of sleep instead of keeping us awake at all hours of the night.

There are 5 major aspects to Cognitive Behavioral Therapy for Insomnia:

Sleep Hygiene

Habits that everyone should know in order to improve your sleep quality. The relevance of these habits to improve your sleep can be more or less important for your particular sleep situation. Take a moment to think about how simple changes like those outlined here can improve sleep. Sometimes its as simple as getting an extra cool blanket for your sleep partner. Learn more

Sleep Restriction or Compression

You should engage in this practice with your doctor, usually a psychologist or psychiatrist trained in CBTi. This involves restricting you time in bed in order to build up your sleep drive and consolidate your sleep. Usually it involves moving your bedtime to a later time in order to ensure you are tired when you go to bed and can sleep throughout the night. Once sleep starts to become more efficient, you then gradually move the time in bed back to a more regular duration. Often times individuals who suffer from insomnia think, "If I can't sleep at night, I'll need to spend much more time in bed to get the sleep I need." They then start to go to bed earlier and earlier. However, this only makes insomnia worse because it results in people not being tired when they go to bed and therefore spending more time awake in bed. Instead, it is recommended to do the exact opposite of this, and hence sleep restriction or sleep compression was developed.

Stimulus Control

Associate your bed with sleeping – save the bed for sleep and sex only. We are like pavlovian dogs, trained to fall asleep and wake up based on cues in our environment. Looking on the bright side, this means we can create cues for ourselves that entrench a deeper night of sleep. Learn more

Relaxation Training

Relaxing sounds and meditation techniques to deactivate the flight or fight response and the always on mentality that many of us are currently suffering from. Every human being should be able to reliably reduce their heart-rate over a 10 minute period. Its ridiculous we don’t teach this in our schools, but you can now get free access to our meditations to help train your brain to relax. Learn more

Myth Busters (cognitive training)

Discover how to think differently about your sleep to overcome maladaptive thoughts that can negatively impact your sleep quality. Sometimes we start to form negative, maladaptive thoughts around sleep after not being able to do it well for so long. Learn more

Healthy sleeping, sleep hygiene concept. Young man sleeping in comfy bed at home, copy space, top view. Millennial guy having nap, resting in white cozy bedroom.