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Is CBT-I Effective?


It works.


CBT-I has been shown to be efficacious with as many as 70-80 percent of patients with primary insomnia. These individuals report benefits including less time to fall asleep (sleep onset latency (SOL), total sleep time (TST), less duration for wake after sleep onset (WASO) and sleep efficiency (SE%).. Additionally these results are often maintained over time. 


(Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis-


It’s often better than medication


Research also suggests that that young and middle-age patients with sleep-onset insomnia can derive significantly greater benefit from CBT than pharmacotherapy and that CBT should be considered a first-line intervention for chronic insomnia


(Cognitive behavior therapy and pharmacotherapy for insomnia: a randomized controlled trial and direct comparison-

It should be the first line of treatment

It is for this reason that the American College of Physicians (ACP) recommends that all adult patients receive cognitive behavioral therapy for insomnia (CBT-I) as the initial treatment for chronic insomnia disorder. Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians

It’s especially effective for those groups that are considered particularly high risk for experiencing insomnia


These groups include individuals with PTSD (Cognitive behavioral therapy for insomnia in posttraumatic stress disorder: a randomized controlled trial-


Pregnant women (Cognitive Behavioral Therapy for Prenatal Insomnia: A Randomized Controlled Trial-


Additionally the quality of the evidence supports a strong recommendation for the use of CBT-I among cancer survivors. (A systematic review and meta-analysis of randomized controlled trials of cognitive behavior therapy for insomnia (CBT-I) in cancer survivors-


The data is so compelling for CBT-I in that it not only works for various types of insomnia (chronic-mixed-sleep maintenance to name a few) but also shows efficacy for people with short term insomnia. This means that CBT-I can also be beneficial for treating insomnia symptoms even in the occurrence that the individual does not meet the clinical criteria for chronic insomnia.  Which means it can be beneficial to almost everyone struggling with falling and staying asleep!

Ok, so CBT-I is great for sleep but does it work if the treatment is delivered virtually?

Since 1996, researchers from the University of Amsterdam have been examining the effects of online cognitive behavioral treatment (online CBT). These studies suggest that online CBT is a viable and effective alternative to face-to-face treatment. Treatment adherence was 82%, and reductions in psychopathology represented a large between-group effect size of SMD = 0.9 (95% CI: .7 to 1.1), which was maintained over long periods. A large study of the treatment outcome of 1,500 patients showed that effects in clinical practice are similar to those observed in the controlled trials, and comparable to selected benchmarks of naturalistic studies of face-to-face CBT. The accumulated evidence provides compelling support for the efficacy and effectiveness of online CBT. Bottom line is it works and just as well! 




A 2016 review of 15 online CBT-I trials found that not only did sleep improve for the participants but that the differences in patient outcomes between online and traditional CBT-I programs were not statistically different, and that online CBT-I  is effective to increase sleep efficiency, and total sleep time, while decreasing insomnia severity and depressive symptoms.


Do the effects of CBT-I last?


In all of the studies cited above the effects were long-lasting. Depending on when the study authors followed up, patients still reported improved symptoms 4 to 48 weeks later. 


Internet-Delivered Cognitive Behavioral Therapy to Treat Insomnia: A Systematic Review and Meta-Analysis (


So if you are having trouble falling and staying asleep what are you waiting for?


You stumped us on this one.

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