🥱 Struggling to Sleep? Why CBT-I Is the Smartest Insomnia Treatment You’ve Never Tried

Like many people in midlife, I’ve been up at 2 a.m., staring at the ceiling, trying everything from warm milk to white noise. If you’re reading this, you probably have too.

Insomnia isn’t just annoying – it steals your energy, your focus, and your joy. And while it’s tempting to reach for a sleeping tablet, the best long-term treatment for insomnia isn’t found in a pharmacy. It’s found in your brain.

Let me introduce you to CBT-I – short for Cognitive Behavioural Therapy for Insomnia.

What Is CBT-I and Why Should You Care?

CBT-I is not about “talking it out” or journaling your dreams. It’s a structured, evidence-based programme that tackles the thoughts and habits that keep you awake.

Unlike pills, which sedate you temporarily, CBT-I helps you retrain your brain for sleep – safely and sustainably. It’s recommended by all major sleep and medical associations as the first-line treatment for chronic insomnia.

How CBT-I Works (No Therapy Couch Required)

CBT-I usually combines several key techniques:

1. Sleep Restriction

Sounds strange, right? But limiting the time you spend in bed (at first) helps strengthen your natural sleep drive. You build sleep pressure – and your brain starts to reconnect bed with deep, restorative sleep.

2. Stimulus Control

This is about breaking the “bed = stress” cycle. If you lie awake tossing and turning, CBT-I teaches you to get up and reset your mind before returning to bed.

3. Cognitive Restructuring

Many of us worry about not sleeping. CBT-I helps you challenge unhelpful thoughts like “I’ll never cope tomorrow” or “I must sleep 8 hours” and replace them with more realistic ones.

4. Relaxation Techniques

Breathing exercises, progressive muscle relaxation, or mindfulness practices reduce the tension that keeps your body on high alert.

5. Sleep Hygiene Education

Yes – your bedroom environment, caffeine use, alcohol, and screen time still matter. But on their own, they’re not enough.

What’s the Evidence?

The research is clear: CBT-I consistently outperforms medication for long-term insomnia relief. Studies show it:

• Reduces the time it takes to fall asleep
• Cuts down night-time waking
• Improves overall sleep quality
• Continues to work months (or even years) later

And – unlike pills – it has zero risk of dependency, hangovers, or grogginess.

What About Sleeping Pills?

Sleeping tablets do have a role – but it’s a limited one.

Modern options like eszopiclone, zolpidem, and orexin blockers (e.g. lemborexant) are more targeted than older sedatives. They can help with short-term flare-ups or when CBT-I isn’t available.

But they also come with side effects:

• Next-day drowsiness
• Memory or concentration problems
• Falls (especially in older adults)
• Tolerance and dependence over time

And many over-the-counter or alternative remedies (looking at you, melatonin and valerian) don’t hold up well in studies.

How Do You Access CBT-I?

• Ask your GP – NHS Talking Therapies often include CBT-I.
• Look for apps – Some digital tools (e.g. Sleepio, Sleepstation, Somryst) are clinically validated and approved.
• Private therapy – If accessible, a trained CBT-I therapist can tailor the programme to you.
• Books and workbooks – For self-starters, resources like “Overcoming Insomnia and Sleep Problems” by Colin Espie are excellent.

Will CBT-I Work for Me?

If your insomnia has lasted more than a few weeks, and especially if it comes with worry or frustration about sleep, CBT-I is likely to help.

The key is commitment. It’s not always easy – sleep restriction, in particular, can feel tough at first. But most people start seeing benefits within 4–6 weeks.

My Take as a GP

I recommend CBT-I all the time. Not because it’s trendy or “natural”, but because it works. It respects your biology, supports your mental health, and restores confidence in your own ability to sleep. 

If you’ve been battling poor sleep, don’t suffer in silence. Ask for CBT-I – or explore one of the trusted digital options. Sleeping better is possible. And it starts not with another pill, but with retraining your brain.

🛏️ Quick Tips While You Wait for CBT-I

• Get up at the same time every day – yes, even weekends.
• Cut screen time an hour before bed.
• If you can’t sleep after 20 minutes, get up and do something quiet until you feel drowsy.
• Avoid naps after 3 p.m.
• Don’t obsess over the clock – turn it away from view.

Final Thoughts

Insomnia is frustrating – but it’s not a life sentence. CBT-I offers a smarter, more sustainable path to restful nights and brighter days. You deserve that.

If you’ve tried it – or want to – let me know what worked (or didn’t). I’d love to hear your experience.

🧠 References

• Management of Insomnia. Morin CM, Buysse DJ. The New England Journal of Medicine. 2024;391(3):247-258. doi:10.1056/NEJMcp2305655.
• Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians. Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD. Annals of Internal Medicine. 2016;165(2):125-33. doi:10.7326/M15-2175.
• Behavioral and Psychological Treatments for Chronic Insomnia Disorder in Adults: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment. Edinger JD, Arnedt JT, Bertisch SM, et al. Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine. 2021;17(2):263-298. doi:10.5664/jcsm.8988.
• Components and Delivery Formats of Cognitive Behavioral Therapy for Chronic Insomnia in Adults: A Systematic Review and Component Network Meta-Analysis. Furukawa Y, Sakata M, Yamamoto R, et al. JAMA Psychiatry. 2024;81(4):357-365. doi:10.1001/jamapsychiatry.2023.5060.
• Network Meta-Analysis Examining Efficacy of Components of Cognitive Behavioural Therapy for Insomnia. Steinmetz L, Simon L, Feige B, et al. Clinical Psychology Review. 2024;114:102507. doi:10.1016/j.cpr.2024.102507.
• Comparative Effects of Pharmacological Interventions for the Acute and Long-Term Management of Insomnia Disorder in Adults: A Systematic Review and Network Meta-Analysis. De Crescenzo F, D'Alò GL, Ostinelli EG, et al. Lancet (London, England). 2022;400(10347):170-184. doi:10.1016/S0140-6736(22)00878-9.
• A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials Evaluating the Evidence Base of Melatonin, Light Exposure, Exercise, and Complementary and Alternative Medicine for Patients With Insomnia Disorder. Baglioni C, Bostanova Z, Bacaro V, et al. Journal of Clinical Medicine. 2020;9(6):E1949. doi:10.3390/jcm9061949.