National Sleep Foundation

Chapter 2: Insomnia

Insomnia Treatment: Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) has been demonstrated to be effective in improving sleep latency1 and sleep maintenance.2, 3, 4, 5 CBT often produces better long-term outcomes than pharmacotherapy.6 Drawbacks to CBT are that it is time-consuming for both therapist and patient, and the therapist’s need for specialized training. A recent study demonstrated that an abbreviated, user-friendly, two-session CBT process successfully reduced insomnia symptoms in primary care patients.7

CBT treatments for insomnia that can be administered by trained sleep or behavioral specialists include the following evidence-based treatments (each is described in more detail in the following sections):

References

  1. Morin CM, Kowatch RA, Barry T, Walton E. Cognitive-behavior therapy for late-life insomnia. J Consult Clin Psychol. 1993;61:137-147.
  2. Edinger JD, Hoelscher TJ, Marsh GR, Lipper S, Ionescu-Pioggia M. A cognitive-behavioral therapy for sleep-maintenance insomnia in older adults. Psychol Aging. 1992;7:282-289.
  3. Morin CM, Colecchi C, Stone J, Sood R, Brink D. Behavioral and pharmacological therapies for late-life insomnia: a randomized controlled trial. JAMA. 1999;281:991-999.
  4. Edinger JD, Wohlgemuth WK, Radtke RA, March GR, Quillian RE. Cognitive behavioral therapy for treatment of chronic primary insomnia: a randomized controlled trial. JAMA. 2001;285:1856-1864.
  5. Edinger JD, Wohlgemuth WK, Krystal AD, Rice JR. Behavioral insomnia therapy for fibromyalgia patients: a randomized clinical trial. Arch Intern Med. 2005;165:2527-2535.
  6. Edinger JD, Means MK. Cognitive-behavioral therapy for primary insomnia. Clin Psychol Rev. 2005;25:539-558.
  7. Edinger JD, Sampson WS. A primary care "friendly" cognitive behavioral insomnia therapy. Sleep. 2003;26:177-182.