Cognitive Behavioral Treatment of Chronic Insomnia

Cognitive behavior therapy for insomnia (CBT-I) is an evidence-based treatment that has been shown to be an effective treatment for chronic insomnia. Chronic insomnia occurs frequently and affects about 10 % of the general population, or 30 million individuals in the USA alone. Furthermore, insomnia is unlikely to spontaneously remit and its impact on the daytime functioning is significant. Insomnia is a risk factor for medical and psychiatric comorbidity as well as impaired work and social performance. Short-term efficacy of CBT-I has been shown to be comparable to sedative-hypnotic medication and CBT-I treatment effects have been shown to be more durable than sedative-hypnotic medication at follow-ups of up to 2 years. The basic components of CBT-I include sleep restriction, stimulus control, and sleepy hygiene interventions. Adjunctive treatments may include relaxation therapy, phototherapy, and cognitive therapy. A step-by-step description of how treatment is delivered is provided as well as behavioral recommendations for primary care patients.