How Effective is Cognitive Behavioural Therapy for Insomnia [CBT-I]?
What the Research Says
CBT-I has been found to be as effective as sleep medications (and sometimes more so), without all the side effects.
However, unlike sleeping pills, which can have many side effects and tend to lose their effectiveness over time [many people end up needing to increase their dose to get the same effect], in research up to two years, CBT-I has been found to continue it’s benefits long after the therapy has ended. In contrast, there is no evidence that sleeping pills have any benefits once treatment stops. In fact, many people find their sleep is worse when they stop long term sleep medications.
CBT-I has been shown to be more effective than relaxation training.
Improving sleep with CBT-I often helps relieve depression and some people find they are able to reduce or stop their anti-depressants as well. In fact, some people taking anti-depressants for years may not have needed them in the first place had they been able to resolve their insomnia first. This is because insomnia can cause depression, as many people know. [*But please do NOT stop taking your medication without consulting your doctor as it can be dangerous and you may end up with severe withdrawal symptoms].
CBT-I can be effective whether you choose to continue your sleep meds or not. [Again, never stop taking your medication without consulting with your doctor.]
Studies have shown CBT-I to be effective even in people with depression, PTSD and chronic pain.
For example, one study of people suffering from both depression and insomnia found that both depression and insomnia severity significantly improved with 4 sessions of CBT-I treatment. Participants who were only receiving self help CBT-I experienced less improvement. Of those receiving CBT-I from a therapist, 61% were in remission from both insomnia and depression at a 3 month follow up, compared to only 5.6% of those who had only done CBT-I in the form of self help written materials.
Research suggests that 5 sessions is usually the best number of sessions. Some people may benefit from 1 or more additional sessions. But for most, 5 is ideal.