What is CBT-I?

CBT-I therapy stands for cognitive behavioural therapy for insomnia. It is a technique for treating insomnia without (or alongside) medications. Insomnia is a common problem involving trouble falling asleep, staying asleep, or getting quality sleep.

How does CBT-I work? What does a session typically entail?

CBT-I is a sleep-specific intervention that is recommended for the treatment of insomnia. It is different to CBT, which focusses on the links between your thoughts, feelings, and behaviours. CBT-I involves a trained CBT-I provider introducing a variety of evidence-based interventions to improve someone’s sleep.

Over the 5 to 6 sessions of a course of CBT-I, the provider will be supporting you with implementing these techniques for long enough for them to bring about an improvement in your sleep. During CBT-I you will learn how to sleep well through making changes to the timing of your sleep. This is in addition to various relaxation techniques for your mind and body.

How many sessions of CBT-I do patients typically receive?

CBT-I therapy is usually a short-term treatment that takes 5 to 6 sessions to be delivered with the guidance and support of a trained CBT-I provider. 

How effective is CBT-I?

It is considered the most effective non-medical intervention to manage insomnia and is recommended as the first line of defence against insomnia by the American College of Physicians.

CBT-I therapy is very effective for treating insomnia when compared with medications, and its effects may last than medications. A systematic review and meta-analysis of 20 studies found that CBT-I improved sleep onset latency, waking up after sleep onset, total sleep time, sleep efficiency, and insomnia severity index scores in adults with insomnia.

The effects of CBT-I were sustained over time and there were no adverse effects of treatment. Another study found that 88% of patients who took a six-session group CBT-I program no longer had clinically significant insomnia by the last session. 

What other treatment options are there for insomnia?

• Medications: Various prescription and over-the-counter drugs can help you fall asleep or stay asleep longer. However, they may have side effects, such as daytime drowsiness, dependence, or withdrawal symptoms. They should only be used under the guidance of a doctor and for a short period.
• Lifestyle changes: Some simple changes in your daily habits and routines can also help you sleep better. For example, you can avoid caffeine, alcohol, nicotine, and heavy meals close to bedtime; exercise regularly but not too late in the day; keep a consistent sleep schedule; create a comfortable and dark sleeping environment; and avoid using electronic devices before bed.