The short answer
CBT for insomnia (CBT-I) is a short course of talking therapy, usually 4 to 8 sessions, that changes the habits and thoughts that keep insomnia going. A review of 20 trials found it helped people fall asleep about 19 minutes faster and spend 26 fewer minutes awake at night. NICE recommends it as the first treatment for long-term insomnia, and it works without pills.
Strong evidence
Several good randomised trials or a solid review of them agree, or very large long-term studies are backed by trials. How we grade
On this page
What is CBT for insomnia?
Cognitive behavioural therapy for insomnia (CBT-I) is a structured treatment aimed at the things that keep insomnia going: irregular sleep times, long hours in bed awake, napping, and racing thoughts and worry about sleep. It’s different from general CBT for anxiety or depression, though it uses some of the same methods.
What does it involve?
A course usually has four to eight sessions, with a therapist, in a group or through an app. It combines several parts:
| Part | What you do |
|---|---|
| Sleep restriction | Limit time in bed to roughly the hours you actually sleep, then extend it as sleep becomes more solid |
| Stimulus control | Use bed only for sleep and sex, go to bed only when sleepy, and get up if you can’t sleep |
| Cognitive therapy | Challenge worries such as “I’ll never cope tomorrow” that make it harder to sleep |
| Relaxation | Techniques to calm body and mind before bed |
| Sleep habits | Caffeine, alcohol, light and a regular wake time |
| Sleep diary | Track your sleep each morning to guide the plan |
Sleep restriction is the most powerful part and the hardest. Spending less time in bed builds up sleep pressure so you fall asleep faster and wake less. For the first week or two you may feel more tired, so take care with driving.
How well does it work?
A 2015 review pooled 20 trials with 1,162 adults with long-term insomnia. Compared with control groups, CBT-I:
- cut the time to fall asleep by about 19 minutes,
- cut time awake during the night by about 26 minutes,
- raised sleep efficiency (the share of time in bed spent asleep) by about 10 percentage points,
- added about 8 minutes of total sleep.
The small rise in total sleep surprises people, but it is expected: CBT-I first consolidates sleep into a shorter, deeper block, and total sleep tends to grow later. Benefits generally last after treatment ends, unlike sleeping pills. US and European sleep guidelines, as well as NICE, recommend it as the first treatment for chronic insomnia.
How do you get it in the UK?
- Through your GP, who may refer you to a psychologist, a sleep service or NHS Talking Therapies, depending on what’s available locally.
- Sleepio, a digital CBT-I programme. NICE recommends it as an option for people with insomnia in primary care, and it’s offered free on the NHS in some areas. It can also be bought directly.
- Privately, from a psychologist trained in CBT-I. Check they are registered with the HCPC or BABCP.
- Self-help books based on CBT-I, which some people find enough on their own.
Who should get advice first?
Sleep restriction makes you sleepier in the short term, which can be risky if you have epilepsy, bipolar disorder or untreated sleep apnoea, or if you drive for a living or operate machinery. These people can still have CBT-I, ideally with a clinician who can adapt the plan.
Keep reading
- Sleep apnoea and snoring: signs, tests and treatment
How to tell ordinary snoring from obstructive sleep apnoea, why apnoea matters, how the NHS tests for it, CPAP and other treatments, and the DVLA rules.
- Restless legs syndrome: causes, self-help and treatment
What restless legs syndrome feels like, its links with iron, pregnancy and kidney disease, what you can do yourself and the treatments a GP may offer.
- Shift work and sleep: how to sleep after night shifts
Why night and early shifts disrupt sleep, the health risks linked to shift work, and practical ways to sleep around a rota, using light, naps and caffeine.
Common questions
How long does CBT for insomnia take to work?
Most courses last 6 to 8 weeks. Many people notice changes within a few weeks, though sleep can feel worse in the first week or two of sleep restriction before it improves.
Can I do CBT for insomnia on my own?
Yes. Digital programmes such as Sleepio, which NICE recommends, deliver it through an app, and there are well-regarded self-help books. Get advice from a GP before starting sleep restriction if you have epilepsy, bipolar disorder, sleep apnoea or a job where sleepiness is dangerous.
Is CBT for insomnia better than sleeping pills?
In the long term, yes. Trials comparing the two find similar benefits in the first few weeks, but the effects of CBT for insomnia last after treatment stops, while sleeping pills stop working when you stop them and carry risks of side effects and dependence.
Does CBT for insomnia work if I also have depression or pain?
Yes. It has been tested in people with depression, anxiety, chronic pain, cancer and other conditions, and generally improves sleep in these groups too. Treating insomnia can also ease depression.
References
- Trauer JM et al. Cognitive behavioral therapy for chronic insomnia: a systematic review and meta-analysis. Annals of Internal Medicine, 2015.pubmed.ncbi.nlm.nih.gov
- NICE. Sleepio to treat insomnia and insomnia symptoms (MTG70), 2022.nice.org.uk
- Edinger JD et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 2021.pubmed.ncbi.nlm.nih.gov
- Freeman D et al. The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis. Lancet Psychiatry, 2017.pubmed.ncbi.nlm.nih.gov
- NHS. Insomnia.nhs.uk
First published 4 November 2026. Spotted an error? Tell us and we'll correct it. Read our editorial policy.