Why is cognitive behavioral therapy the first-line treatment for chronic insomnia?

CBT-I is a structured treatment for chronic insomnia. It focuses on the link between sleep, daily routines, and thoughts about bedtime. It is different from general talk therapy and goes beyond advice such as avoiding caffeine or keeping your room dark.

Treatment may include keeping a steady wake time, using the bed mainly for sleep, and reducing time spent lying awake in bed. Another part addresses worry about sleep. A clinician may also adjust your time in bed to better match the time you actually sleep, then change that schedule as needed.

CBT-I can improve sleep and may provide benefits after treatment ends. Results vary. It takes practice, and some steps can temporarily increase daytime sleepiness. A trained clinician should guide changes, especially if you have bipolar disorder, seizures, or a job that requires constant alertness.

Ask your physician about access to a trained CBT-I provider or an evidence-based digital program. Medication may sometimes be used alongside CBT-I, but it does not replace learning skills that address ongoing insomnia.