Research digest — not medical advice. Full disclaimer · How we rate evidence
CBT-I
Gold standard for insomnia
Overview
Cognitive Behavioural Therapy for Insomnia. First-line treatment for chronic insomnia in every major clinical guideline, and more effective than sleep medication long-term.
How it works
Combines sleep restriction (temporarily limiting time in bed to build sleep drive), stimulus control (breaking the bed-is-for-wakefulness association), and cognitive restructuring of sleep-related anxiety.
Benefits
Insomnia remission: long-term resolution of chronic insomnia in roughly 70% of completers.
A
Protocol
- 1Sleep restriction: limit time in bed to match actual sleep time, then gradually expand.
- 2Stimulus control: get out of bed if you are not asleep within 20 minutes.
- 3Cognitive restructuring: identify and challenge catastrophic thinking about sleep loss.
- 4Best delivered by a trained therapist or via a validated app (Sleepio, SHUTi, Somryst).
Safety Profile
Side Effects
| Effect | Severity | Frequency |
|---|---|---|
| Initial fatigue during the sleep restriction phase | minor | common |
Contraindications
- Bipolar mania (caution — can trigger an episode)
- Untreated severe sleep apnoea
Research Summary
First-line treatment for chronic insomnia in every major clinical guideline. More effective than sleep medication long-term. Not widely available in Canada outside major cities, but app-based versions are NICE- and FDA-recognised.
Sources
- •Cognitive behavioral therapy for chronic insomnia: a systematic review and meta-analysis(2015)
- •Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians(2016)
- •Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline(2021)
Last updated: 2026-04-10
Sidebar
Medical Disclaimer
This is a research summary, not medical advice. Body Signals is an independent research digest — it summarises published research for informational purposes and is not a healthcare provider. Supplements like melatonin, valerian, and magnesium can interact with prescription medications — check with your doctor or pharmacist before starting any supplement. Chronic insomnia may indicate an underlying condition (sleep apnoea, thyroid dysfunction, depression) and warrants a medical evaluation.
Need professional guidance?
If sleep issues persist despite lifestyle changes, a sleep specialist or your family doctor can help rule out underlying conditions.
Learn about sleep specialists