Sleep Better: CBT-I Starter Guide
Evidence-based strategies to improve sleep: sleep hygiene, stimulus control, sleep restriction, and when to seek professional help.
Clinically Reviewed: Licensed Clinical Psychologist |Next Review: October 2025
Key Takeaways
- CBT-I is gold-standard insomnia treatment with lasting results
- Core techniques: sleep restriction, stimulus control, sleep hygiene
- Most people see improvement within 2-4 weeks of consistent practice
- Benefits continue after treatment—skills work long-term
- No medication side effects or dependence risks
Core CBT-I Techniques
- Sleep Restriction: Match time in bed to actual sleep time
- Stimulus Control: Retrain bed = sleep association
- Sleep Hygiene: Optimize environment and behaviors
- Cognitive Therapy: Address anxious thoughts about sleep
- Relaxation: Progressive muscle relaxation, imagery
Sleep Hygiene Basics
- Consistent sleep schedule (same bedtime/wake time daily)
- Dark, cool, quiet bedroom (60-67°F ideal)
- No screens 1 hour before bed
- Avoid caffeine after 2pm
- Limit alcohol (disrupts sleep quality)
- Exercise regularly (but not within 3 hours of bedtime)
Frequently Asked Questions
What is CBT-I?
Cognitive Behavioral Therapy for Insomnia is a structured program teaching behavioral and cognitive strategies to improve sleep without medication. It addresses the thoughts and behaviors keeping insomnia going.
What is sleep restriction?
Temporarily limiting time in bed to match actual sleep time, then gradually expanding sleep window as sleep improves. It sounds counterintuitive but rebuilds sleep drive and consolidates sleep.
What's stimulus control?
Retraining your brain that bed = sleep (not worry, TV, scrolling phone). Rules include: only go to bed when sleepy, get out of bed if awake 20+ minutes, use bed only for sleep and sex.
How long does CBT-I take to work?
Most people notice improvement within 2-4 weeks of consistently applying techniques. Unlike medication (works immediately), CBT-I builds gradually but results last.
Can I do CBT-I while taking sleep medication?
Yes, though the goal is often to taper medication as CBT-I skills improve sleep. Combining both initially, then reducing medication, is a common and effective approach.
What if I work night shifts?
CBT-I can be adapted for shift workers. The principles (consistent sleep schedule, optimizing sleep environment, managing circadian rhythm) still apply but require modification for your schedule.
References
- 1. Edinger JD, et al. (2021). "Behavioral and psychological treatments for chronic insomnia disorder in adults." J Clin Sleep Med 17(2):255-262.
- 2. Morin CM, et al. (2006). "Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia." JAMA 296(17):2152-2160.