cognitive behavioural therapy for insomnia

Cognitive behavioural therapy for insomnia is a structured programme, usually four to eight sessions, guided by a sleep diary the person keeps throughout. The American Academy of Sleep Medicine describes it as combining one or more cognitive therapy strategies with education about sleep regulation, plus stimulus control instructions and sleep restriction therapy, and notes that it often adds relaxation training and other counter arousal methods.

Two of those components do most of the work, and both ask for something that feels wrong. Sleep restriction deliberately shortens the time spent in bed to match the hours actually slept, then extends it again as sleep becomes more consolidated. Stimulus control breaks the learned association between the bed and lying awake, largely by having people get out of bed when sleep does not come. The cognitive part targets the beliefs and the worry about sleeping that often keep insomnia going long after whatever started it has passed.

It is not sleep hygiene advice, and it is not what most sleep tracking or relaxation apps deliver. The American Academy of Sleep Medicine gives multicomponent cognitive behavioural therapy for insomnia a strong recommendation for chronic insomnia disorder in adults, resting on moderate quality evidence from 49 studies.