CBT-I: The Gold Standard
Cognitive Behavioral Therapy for Insomnia is the only treatment recommended by the American College of Physicians as the first-line defense against chronic sleeplessness.
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Why Medication Isn't Enough
Sleeping pills sedate you; they do not produce "natural" sleep. They bypass the restorative stages of deep sleep and REM. CBT-I creates natural sleep pressure by realigning your body's drives.
How CBT-I Works
CBT-I is a structured program (usually 4-8 weeks) that targets the thoughts and behaviors keeping you awake. It consists of five core pillars:
Sleep Restriction
Temporarily limiting time in bed to increase 'Sleep Drive', making you physically tired enough to sleep through the night.
Stimulus Control
Retraining your brain to associate the bed ONLY with sleep, breaking the 'Bed = Anxiety' connection.
Cognitive Restructuring
Challenging the racing thoughts and anxiety ('If I don't sleep now, I'll fail tomorrow') that keep you awake.
Sleep Hygiene
Optimizing your environment (light, temperature, noise) and habits (caffeine, screen time).
Relaxation Training
Techniques to lower physiological arousal (heart rate, muscle tension) before bed.
Who is CBT-I For?
- People who have trouble falling asleep (>30 mins).
- People who wake up in the middle of the night and can't return to sleep.
- Patients wishing to reduce or eliminate sleep medications.
- "Short sleepers" who feel unrefreshed despite time in bed.
Last reviewed: February 2026 by Dr. Vikas Jain, MD, FAASM, Board-Certified Sleep Medicine Specialist
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