If you’ve ever found yourself lying awake night after night, eyes heavy but mind racing, you know how isolating insomnia can feel. Maybe you’ve tried multiple sleep aids, downloaded meditation apps, and even changed your diet, only to hear from your doctor, “Try to relax,” or “Here’s a prescription,” or “It’s just your hormones.” It’s frustrating—especially when you’ve already spent countless hours working on improving your sleep. But what if I told you that, for many people with chronic insomnia, the answer goes beyond a dark room and supplements?
When you visit your doctor for sleep problems, they often recommend improving your sleep hygiene—and while that’s important for maintaining quality sleep, it’s rarely enough to tackle chronic insomnia. Sleep hygiene covers things like sticking to a regular bedtime, limiting screen time, and creating a calm environment. These habits are useful for optimizing your sleep and keeping sleep on track, but won’t fix the root cause of chronic insomnia. Why? Because chronic insomnia isn’t just about your surroundings or lifestyle; it’s about your thoughts and behaviours around sleep. The good news? The frustratingly anxious thoughts and unhelpful behaviours that you currently have- they can all be unlearned.
Enter Cognitive Behavioral Therapy for Insomnia (CBT-I), a proven approach that dives into addressing the root causes of your insomnia.
In this blog, we’re going to unpack Cognitive Behavioral Therapy for Insomnia (CBT-I). We’ll dive into what CBT-I actually is, how it works to treat insomnia in adults, and how effective it can be. So, if you feel like you’ve tried everything else already, you might as well keep reading so we can get to the root issue of your chronic insomnia!
What is Cognitive Behavioral Therapy for Insomnia (CBT-I)?
CBT-I is a highly effective, evidence-based treatment designed to help people overcome chronic insomnia. Unlike sleep medications, which often provide only temporary relief, CBT-I addresses the underlying thoughts and behaviours that keep you awake at night. It focuses on changing the mental and emotional patterns that fuel insomnia, helping to break the cycle of sleeplessness.
At its core, CBT-I is about understanding the relationship between your thoughts, feelings, and sleep habits. Many people with insomnia develop a pattern of anxiety or frustration around bedtime. This might look like worrying about not being able to sleep, clock-watching throughout the night, or even developing negative associations with your bed. These thoughts can create stress, which ironically makes it harder to fall asleep, perpetuating the insomnia cycle. CBT-I can help you become more aware of these patterns so you can actively work to change them.
Through CBT-I you’ll be introduced to strategies that will help you tackle both the cognitive (thoughts and feelings) and behavioural (habits) aspects of insomnia. Over time, you’ll build healthier sleep habits and change how you think about sleep.
So how does CBT-I actually work?
I’m so glad you asked! Let’s break CBT-I down more and go through the various components it focuses on:
Challenging unhelpful thoughts about sleep: One of the most common problems adults face when it comes to insomnia is the anxiety that builds around sleep itself. You may recognize some of these frequent thoughts:
“Will I ever fall asleep tonight?”
“If I don’t fall asleep soon, tomorrow will be terrible.”
“I’ve already missed 2 hours of sleep by laying here awake.”
" I have only 3 more hours until my alarm goes off."
These negative sleep thoughts often become self-fulfilling prophecies, increasing stress and making it even harder to fall asleep. However, CBT-I helps you become aware of these unhelpful thought patterns and teaches you how to challenge and replace them with more realistic thoughts- also known as cognitive restructuring. Instead of focusing on the pressure of falling asleep, you can learn to reframe these thoughts in a way that will reduce your anxiety and ultimately help you approach bedtime with a calmer, more relaxed mindset. See below for some neutral thoughts to use in replace of your negative ones:
"I don’t need to force sleep. My body knows how to rest, and when I’m calm and relaxed, sleep will come naturally."
“I will fall asleep sooner or later”
"Even if I don’t get as much sleep as I’d like tonight, I can still function and get through the day.”
“I can still use this time to relax and unwind. Even resting quietly is beneficial for my body and mind.”
Creating healthy sleep behaviours: Over time, insomnia can condition your body to associate your bed with wakefulness, tossing, and turning. Basically, it's the opposite of what you want your bed to be associated with! CBT-I tackles this issue through techniques like sleep scheduling, which limits the amount of time you spend in bed to the actual hours you sleep. This may sound counterproductive at first, but it’s designed to retrain your body to associate your bed only with sleep instead of frustration or wakefulness.
Relaxation training: For many people, a racing mind at bedtime can be a major obstacle to sleep. That’s why CBT-I includes relaxation techniques such as deep breathing and progressive muscle relaxation. These exercises help calm both the mind and the body, creating a state of relaxation that makes it easier to drift off.
These tools aren’t just about relaxing in the moment though- they’re about teaching your body how to wind down effectively, reducing the overall tension in your body and promoting a smoother transition into sleep. In my adult sleep program, I teach you how to use these tools first during the day and then during the night when it’s time to sleep.
Improving sleep efficiency: With chronic insomnia, it’s not just the amount of sleep you get but the quality of sleep that matters, too. CBT-I focuses on improving your sleep efficiency (which is directly related to your sleep quality). Sleep efficiency is the percentage of time you spend actually asleep while in bed. Each of my clients tracks their sleep using an app, and with this data, we can monitor sleep efficiency to ensure it's increasing. Through the structured techniques of CBT-I, you’ll create a routine that maximizes the efficiency of your sleep time, leading to deeper, more restorative sleep.
Sleep hygiene: Lastly, once we have sufficiently addressed the root cause of your insomnia, then we’ll get to work on optimizing your sleep even more by working on your sleep hygiene. This would include aspects like your bedtime routine, timing and frequency of alcohol and caffeine consumption, making sure your sleep environment is optimal, and other areas that can often get skipped over. Basically, once you’re able to fall asleep easier, we want to make sure the quality of your sleep is as good as it can be.
But is CBT-I effective for chronic insomnia?
I get it. CBT-I sounds great and all, but does it actually help improve chronic insomnia? The good news is that it does! Studies have repeatedly shown the effectiveness of CBT-I. But don’t take my word for it; let’s discuss the results from just two different research articles.
This review looked at 5 different studies on the use of CBT-I to treat insomnia versus using prescription medication. After reviewing and summarizing these studies, the researchers came to the conclusion that “CBT-I is effective for treating insomnia when compared with medications, and its effects may be more durable than medications.” They even went as far as to point out that “Primary care providers should consider CBT-I as a first-line treatment option for insomnia.”
And this review touts a success rate of “70% to 80% of patients” when CBT-I is used for chronic insomnia, stating “that it can significantly reduce several measures of insomnia, including sleep-onset latency and wake-after-sleep onset.” It even goes a step further to mention that for those who suffer from chronic insomnia, CBT-I “enables many patients to regain a feeling of control over their sleep, thereby reducing the emotional distress that sleep disturbances cause.”
Finally, The Mayo clinic writes "Insomnia is a common sleep disorder that can make it hard to fall asleep or stay asleep. It also can cause you to wake up too early and not be able to get back to sleep. Cognitive behavioral therapy, sometimes called CBT, can effectively treat long-term sleep problems like insomnia. Generally, it's the first treatment recommended.
Cognitive behavioural therapy for insomnia is shown to be safe and effective for the treatment of chronic insomnia.
In conclusion
If you’ve been struggling with chronic insomnia and feeling lost in a sea of quick fixes, remember that you’re not alone. Many adults face the same frustrating experience- visiting their healthcare provider only to be asked, “Have you tried relaxing before bed?" or handed a prescription without any real guidance. My goal with this blog is to empower you with the knowledge that there is a solution, even if it’s not what you’ve been told before.
CBT-I offers a comprehensive approach to tackle the root causes of your sleep struggles. By changing the negative thoughts and unhelpful behaviours surrounding sleep, CBT-I can help you establish healthier patterns so you can finally start having a consistent night of sleep. It’s not just about creating a dark room or avoiding coffee late in the day; it’s about reprogramming your mindset toward sleep itself.
If you’re feeling stuck in a cycle of broken sleep, I can help! I'd love to get to know your sleep story, and together, we can decide if my program is the right fit for you.
Book your free 20-minute call below!