What Is CBT-I? The Proven Insomnia Treatment Most People Haven’t Tried
- Phoebe Walsh
- Apr 7
- 4 min read
Struggling with sleep that just won’t fix itself—no matter how many herbal teas or sleep apps you try? You’re not alone. Chronic insomnia affects up to one in three adults in the UK, and while many reach for over-the-counter sleep aids or prescriptions, there’s a scientifically proven treatment that’s still underused: Cognitive Behavioural Therapy for Insomnia, or CBT-I.
Unlike sleeping pills, which offer short-term relief, CBT-I addresses the root causes of insomnia. It rewires the way you think about and approach sleep—without medication, side effects, or risk of dependency. It’s recommended by the NHS, British Sleep Society, and American Academy of Sleep Medicine as the first-line treatment for chronic insomnia.
Yet surprisingly, many people have never heard of it.
This guide breaks down exactly what CBT-I is, how it works, why it’s so effective, and how you can access it in the UK—whether through the NHS, private clinics, or online tools.
What Is CBT-I?
CBT-I (Cognitive Behavioural Therapy for Insomnia) is a structured, evidence-based approach designed to treat chronic insomnia by changing the behaviours, thoughts, and habits that interfere with sleep. It doesn’t rely on medication. Instead, it helps retrain your brain and body to sleep naturally again.
CBT-I is different from general CBT. It’s tailored specifically to sleep problems and delivered in a short, practical format—typically over 4 to 8 weeks.
CBT-I includes five core components:
Sleep restriction – Aligns your time in bed with actual sleep time
Stimulus control – Rebuilds your association between bed and sleep
Cognitive restructuring – Challenges unhelpful thoughts that fuel insomnia
Sleep hygiene – Optimises your environment and pre-sleep routine
Relaxation strategies – Reduces physical and mental arousal before bed
How Does CBT-I Actually Work?
1. Sleep Restriction
This sounds harsh but it’s incredibly effective. CBT-I reduces your time in bed to match your actual sleep time—say, 5.5 hours if that’s how long you sleep. It builds up sleep pressure, so your body becomes more efficient at falling and staying asleep. Over time, your sleep window is gradually expanded as sleep improves.
2. Stimulus Control
This component teaches your brain that bed means sleep—not worrying, scrolling, or watching TV. You’ll learn to:
Only go to bed when sleepy
Leave the bed after 20 minutes if you can’t sleep
Wake up at the same time every day
Avoid all non-sleep activities in bed
3. Cognitive Restructuring
People with insomnia often develop anxious, distorted thoughts about sleep:
“If I don’t fall asleep soon, I’ll ruin tomorrow.”
“I’ve lost the ability to sleep.”
CBT-I helps you challenge and replace these thoughts with more balanced beliefs.
4. Sleep Hygiene Education
Good sleep hygiene won’t fix chronic insomnia alone—but it supports long-term progress.
You’ll learn to:
Reduce caffeine, alcohol, and screen use at night
Create a consistent bedtime routine
Make your bedroom dark, cool, and quiet
5. Relaxation Training
CBT-I may include deep breathing, progressive muscle relaxation, or mindfulness techniques to help calm racing thoughts and physical tension.
Why Is CBT-I So Effective?
CBT-I isn’t just another wellness trend—it’s backed by decades of clinical research.
Benefits of CBT-I:
Improves sleep latency (how fast you fall asleep)
Reduces night-time waking
Increases sleep quality and efficiency
Delivers long-term results—often years after treatment ends
Doesn’t involve medication, so there’s no risk of dependency or next-day grogginess
A major 2015 meta-analysis in Annals of Internal Medicine found CBT-I was more effective than sleeping pills for long-term sleep improvement. Over 70% of people experience better sleep after CBT-I.
Who Should Try CBT-I?
CBT-I works for most types of insomnia, including:
Trouble falling asleep (onset insomnia)
Waking in the night or too early (maintenance insomnia)
Short-term stress-related sleep problems
Long-standing, chronic insomnia
It’s also suitable for people with comorbid issues such as:
Anxiety and depression
Menopausal symptoms
Sleep disturbances from shift work or jet lag
CBT-I is not recommended for people with untreated sleep apnoea or parasomnias unless under specialist care.
What Happens in a CBT-I Programme?
CBT-I typically involves weekly sessions over 4–8 weeks, delivered in person, online, or via self-guided apps.
A typical course includes:
A sleep diary to track patterns and progress
Adjustments to your sleep schedule (including restriction and stimulus control)
Thought-challenging techniques
Relaxation and habit-building tools
CBT-I is available in the UK through:
NHS Talking Therapies (search your local area for self-referral options)
Private therapists trained in CBT-I
Digital CBT-I tools like Sleepio (NHS-approved in some regions) or Somryst
Is CBT-I Covered by the NHS?
Yes—CBT-I is available through NHS Talking Therapies services. While not every practitioner is CBT-I trained, many areas offer:
One-to-one CBT-I sessions
Group CBT for insomnia
Access to approved apps like Sleepio
Ask your GP for a referral or self-refer online by searching “NHS Talking Therapies” + your local area.
Does CBT-I Have Side Effects?
CBT-I is very safe—but the first couple of weeks can be challenging:
You may feel more tired during sleep restriction
Sleep may temporarily feel worse before it improves
These are normal and temporary. Most people notice significant improvement by week 3 or 4.
Final Thoughts: Why CBT-I Deserves More Attention
CBT-I is not a quick fix—but it’s the most effective long-term solution for chronic insomnia. It teaches you how to sleep well again, without medication, and gives you tools to manage future setbacks. Whether your insomnia has lasted weeks or years, CBT-I offers real hope—and real results.
Bottom line: If sleep has become a nightly battle and nothing seems to work, CBT-I may be the missing piece. It’s evidence-based, drug-free, and available on the NHS. Don’t wait to get help—because better sleep changes everything.
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