Roughly one in ten adults suffer from insomnia. Often, insomnia begins when natural sleep is disrupted by something external (a stressor, illness, work schedule, or life change), but it can persist long after the original disruption has ended. In addition to fatigue, insomnia may also involve significant anxiety about your sleep, significant time and energy trying to improve sleep, and painful nights tossing and turning. Insomnia significantly impairs mood, concentration, and quality of life.

I treat insomnia using cognitive behavioral therapy for insomnia (CBT-I). CBT-I is the most effective long-term treatment available, producing better long-term outcomes than sleep medication and without the risks of dependence or tolerance. CBT-I is recommended as the first-line treatment for chronic insomnia by the American College of Physicians and the American Academy of Sleep Medicine.

CBT-I is effective for adults with a variety of sleep problems. It is effective for primary insomnia as well as insomnia co-occurring with anxiety, depression, chronic pain, or other conditions.

How it works

CBT-I addresses the behavioral patterns and beliefs that perpetuate insomnia over time. Treatment typically includes:

Stimulus control: rebuilding the bed and bedroom as cues for sleep rather than wakefulness or worry
Cognitive restructuring: addressing unhelpful beliefs about sleep that maintain the cycle of insomnia
Sleep hygiene: tailored adjustments to sleep environment and pre-sleep routine
Sleep restriction: consolidating sleep to strengthen the drive to sleep and re-establish the association between bed and sleep

CBT-I typically involves 6–8 sessions. Many people notice meaningful improvement within the first few weeks of treatment.