CBT-I (Cognitive Behavioral Therapy for Insomnia) is a behavioral treatment approach specifically developed for treating insomnia. It consists of several treatment components – based on cognitive behavioral therapy (CBT)1 principles – that are commonly used together to treat insomnia. Because it is a multi-component approach, there isn’t one authoritative or manualized version of CBT-I; instead you’ll find different variations with slightly different emphases based on the researcher or the author of the protocol.
CBT-I is considered to be the most effective non-medication-based treatment for insomnia (and in fact has been shown by research studies to be more effective than medications in the long term) and is overwhelmingly recommended as the first line treatment for insomnia.2 CBT-I is the modality that I have been trained in and utilize at my clinic (day job) to treat clients with insomnia, with great efficacy. I created this primer for anyone who wanted to learn more about the specifics of CBT-I.
A brief history of CBT-I
As I mentioned earlier, CBT-I isn’t a single structured intervention created at one point in time, but one that is made up of multiple components and has had many contributors as it evolved over the years. Prior to the 1970’s, teaching relaxation techniques (including progressive muscle relaxation) was the primary behavioral/psychological tool for treating insomnia. In the early 1970s, psychologist Richard Bootzin developed a method called stimulus control therapy,3 which focused on preserving the bed and bedroom as a cue for sleep, and which turned out to be a critical component of CBT-I. In the late 1970s, the concept of “sleep hygiene” as we now understand it in sleep medicine was introduced by psychologist Peter Hauri.4