How CBTI Works

Doctors have recognized Cognitive Behavioral Therapy for Insomnia (CBT-I) as the gold standard treatment for insomnia with over 40 years of research showing over 90% efficacy.

Cognitive restructuring

A core principle in CBT-I is that the way we sleep is influenced by our thoughts and feelings about sleep. People with insomnia often have dysfunctional thoughts about sleep that result in behaviors that are detrimental to good sleep.

Cognitive restructuring attempts to break this destructive feedback loop by identifying, challenging and reframing the thoughts and feelings that contribute to insomnia. For example, many insomniacs have distortive thoughts such as thinking “Oh my god, it’s been 15 minutes but I still haven’t fallen asleep. I’m never going to be able to fall asleep”. These thoughts, in addition to being logically wrong, also create a negative stress cycle where the longer you can’t fall asleep, the more you think these thoughts, the more stressed you become, and the more unlikely you are to fall asleep soon.

Stimulus control

Stimulus control is based on the psychology of conditioning. Classical conditioning was first studied by the Russian scientist Ivan Pavlov in 1897. Pavlov observed in a series of experiments with dogs that he can provoke a conditioned response (salivation) to a previously neutral stimulus (a bell ringing). Similarly, people with insomnia often associate wakefulness (conditioned response) to their bedroom (stimulus) due to habits such as reading, watching TV or using devices in bed.

Sleep restriction

Sleep restriction therapy is one of the most powerful tools in sleep psychology and has been extensively researched. People with insomnia often find it counterintuitive that you have to try to stay awake in order to get better sleep, but this is fundamental psychology at work. You’re so sleepy by the time you hit the pillow that you immediately fall into a deep, restorative sleep. In time, your mind starts forming a strong, permanent association between your bed and quickly falling into a restorative sleep. This association will benefit your sleep for the rest of your life.