Cognitive Behavioral Therapy for Insomnia (CBT-I): A Primer

Abstract

Cognitive Behavioral Therapy for Insomnia (CBT-I) is a multi-component treatment for insomnia that targets difficulties with initiating and/or maintaining sleep and is delivered over the course of six to eight sessions. The primary focus of CBT-I is to address the perpetuating factors (according to the three-factor model of insomnia) that contribute to the development of chronic insomnia. Chronic insomnia is the most prevalent sleep disorder, occurring in approximately 6–10% of the population, and is a risk factor for multiple medical and psychiatric disorders. Despite its prevalence and morbidity, the widespread dissemination of CBT-I is not commensurate with insomnia’s overall public health impact. This is particularly surprising given its large evidence base and recent recommendation as the first line intervention for insomnia. The primary goal of this article is to provide a primer or brief introduction to CBT-I that is intended to be accessible to all clinicians and researchers, including non-sleep experts. Core components of CBT-I (i.e., Sleep Restriction Therapy, Stimulus Control Therapy, Sleep Hygiene, and Cognitive Therapy), relapse prevention strategies, multicultural considerations, adjuvants to traditional interventions, treatment adherence issues, efficacy, and further training options are described. A session-by-session outline is also provided.

Harnessing Positive Thinking: A Cognitive Behavioural Approach to Stress Management

“…This study highlights the effectiveness of CBT in treating PTSD, making a valuable contribution to understanding best treatment practices. Walker et al (2022) introduced cognitive behavioral therapy for insomnia (CBT-I) as a primary treatment method for insomnia. This review highlights the importance of CBT-I in improving sleep quality.…”

Pharmacological Treatment of Primary Insomnia in Senior Citizens in Spain

“…The GABA-A receptor, responsible for inhibiting the central nervous system, includes the benzodiazepine receptor as one of its essential parts. By binding to a specific site on the GABA receptor, benzodiazepines increase the affinity of the GABA neurotransmitter [22], resulting in increased GABAergic inhibitory transmission (Figure 3). This increased inhibitory transmission leads to calming, sleep-inducing, relaxing, and anti-seizure effects.…”

Developing a novel mobile application for cognitive behavioral therapy for insomnia for people with schizophrenia: integration of wearable and environmental sleep sensors

“…Studies have shown the beneficial effects of CBT-i for psychiatric populations [ 6 ], though studies including patients with serious mental illnesses (SMI), such as schizophrenia or bipolar disorder, are limited [ 8 – 11 ]. Despite the benefits of CBT-i and the lack of associated side effects, one major barrier to successful CBT-i is the lack of adherence to the sleep diaries, which informs the specific changes for each individual [ 12 ]. In particular, individuals with SMI may have challenges in completing the nightly sleep diaries due to irregular routines and working memory deficits [ 12 , 13 ].…”

“…Despite the benefits of CBT-i and the lack of associated side effects, one major barrier to successful CBT-i is the lack of adherence to the sleep diaries, which informs the specific changes for each individual [ 12 ]. In particular, individuals with SMI may have challenges in completing the nightly sleep diaries due to irregular routines and working memory deficits [ 12 , 13 ]. In addition, commercially available CBT-i mobile applications (e.g., CBT-i Coach, Sleepio, Shuteye, and Somyrst) include tools to improve their sleep though their usability for clinical populations may be limited.…”