Insomnia is a common sleep disorder that can make it hard to fall asleep, hard to stay asleep, or cause you to wake up too early and not be able to get back to sleep. Cognitive behavioral therapy for insomnia, or CBTi, is an effective treatment for chronic sleep problems and is usually recommended as the first line of treatment.

CBTi is a structured program that helps you identify and replace thoughts and behaviors that cause or worsen sleep problems with habits that promote sound sleep. Unlike sleeping pills, CBTi helps you overcome the underlying causes of your sleep problems and result in lasting improvement in sleep.

How does cognitive behavioral therapy for insomnia work?

The cognitive part of CBT-I teaches you to recognize and change beliefs that affect your ability to sleep. This type of therapy can help you control or eliminate negative thoughts and worries that keep you awake.

The behavioral part of CBT-I helps you develop good sleep habits and avoid behaviors that keep you from sleeping well.

Cognitive behavioral therapy vs. sleep medications

Sleep medications can be an effective short-term treatment — for example, they can provide immediate relief during a period of high stress or grief. Some newer sleeping medications have been approved for longer use. But they may not be the best long-term insomnia treatment.

Cognitive behavioral therapy for insomnia may be a good treatment choice if you have long-term sleep problems, you’re worried about becoming dependent on sleep medications, or if medications aren’t effective or cause bothersome side effects.

Unlike pills, CBTi addresses the underlying causes of insomnia rather than just relieving symptoms. But it takes time — and effort — to make it work. In some cases, a combination of sleep medication and CBT-I may be the best approach.