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CBT-I & Sleep Hygiene

Reviewed by the Nimbera editorial team · Last updated May 2026

Trauer et al. 2015 Annals of Internal Medicine (PMID 26054060) - Systematic review and meta-analysis of 20 RCTs (1,162 participants) found CBT-I reduced sleep onset latency by 19.03 min (95% CI 14.12-23.93), reduced wake after sleep onset by 26.00 min (95% CI 15.48-36.52), and improved sleep efficiency by 9.91% (95% CI 8.09-11.73%), with benefits sustained at follow-up.$0-50/month (app-based); $150-200/session with therapist

How to use

Core components: (1) Stimulus control - use bed only for sleep and sex, get up if awake more than 20 min. (2) Sleep restriction - initially limit time in bed to actual sleep time, then extend by 15-min increments. (3) Fixed wake time daily including weekends. (4) Cognitive restructuring of unhelpful beliefs about sleep. (5) Relaxation training (progressive muscle relaxation or diaphragmatic breathing). Work with a CBT-I trained therapist or use validated apps (Somryst, Sleepio).

How it works

CBT-I targets the behavioral and cognitive factors that perpetuate chronic insomnia. Sleep restriction builds homeostatic sleep drive. Stimulus control reconsolidates the mental association between bed and sleepiness. Cognitive restructuring reduces hyperarousal and sleep-related anxiety that prevents sleep onset.

Where to buy

Sleepio app (digital CBT-I): free with some insurers or $300-400/year. Somryst (FDA-cleared): ~$900 (may be covered by insurance). Books: "Say Good Night to Insomnia" by Dr. Gregg Jacobs (~$15). Free CBT-I Coach app from the VA. Therapist-guided CBT-I: $100-200/session, typically 6-8 sessions.

Typical cost: $0-50/month (app-based); $150-200/session with therapist

Safety notes

Sleep restriction phase may temporarily increase daytime sleepiness - avoid driving when impaired. Not appropriate as a standalone treatment if insomnia is secondary to untreated sleep apnea, bipolar disorder (mania risk), or seizure disorders without medical supervision. Work with a qualified provider if symptoms are complex.

Drug & supplement interactions

  • Always tell your doctor or pharmacist about any supplements you take.
  • Interactions can occur with prescription medications, blood thinners, and immunosuppressants.
  • Herbal remedies can affect how the body absorbs or metabolises drugs.
  • Check drugs.com interactions checker before starting.

Clinical source

Trauer 2015 - Annals of Internal Medicine (PMID 26054060)

This information is compiled from primary clinical literature and is for informational purposes only. It is not a substitute for professional medical advice. Read our full disclaimer.