Cognitive behavioural therapy for insomnia (CBT-i)

What is CBT-i?

CBT-i is the ‘gold-standard’ treatment for sleep problems. It is a structured treatment program that helps people improve their sleep. It is recommended before taking sleep pills.

In patients with mild sleep troubles, CBT-i strategies can help improve symptoms and prevent sleep troubles from getting worse.

CBT-i helps you change habits, routines, and thoughts that are negatively affecting your sleep, through:

• Sleep restriction: Spend less time in bed so you sleep more deeply and in one block of time.
  
• Stimulus control: Change unhelpful behaviours so your bed is linked only with sleep.
  
• Sleep hygiene or healthy sleep habits: The everyday behaviours and practices that support good-quality sleep and daytime energy.
• Cognitive restructuring: Learn to manage unhelpful thoughts that make it hard to sleep.

How it works

CBT-i is usually done with a psychologist who had special training. The program runs over several weeks. You will complete exercises and practice specific techniques. You will keep a sleep diary to track your sleep and thoughts. Your therapist will review your diary and give you personalized feedback.

The "CBT-I for Insomnia” video from PsychHub gives you a more detailed look at CBT-i.

You can do also do CBT-i on your own, with self-help options.

CBT-i with a psychologist

If you want to follow a psychologist-led CBT‑i program, you’ll need to find services in the community.

Concordia students have some coverage for psychological services through their student insurance plans. For staff and faculty, CBT-i is not available through the Employee Assistance Program (EAP), but the Concordia Health Plan (scroll down to "Psychologists and psychiatrists") or other private insurance can help pay for these services.

A few local centers that offer CBT-i include:

• the Insomnia Clinic at the Jewish General Hospital
  
• the Emotional Health CBT Clinic in NDG
• PSYMontreal: Students covered by the Concordia undergraduate student health insurance plan can get a discounted price by using the preferred rate negotiated by the CSU.
• Neurotherapie Montreal specializes in evaluation and treatment of sleep disorders 
• Blake Psychology: in-person and online appointments available

Self-help options

You can use a workbook or an online/app-based program.

CBT-i workbooks include:

• Sink into Sleep: A Step-by-Step Workbook for Reversing Insomnia

These next ones are available to borrow from the Montreal libraries. You can ask them to send the book to your local library.

• The Insomnia Workbook: A Comprehensive Guide to Getting the Sleep You Need
• Goodnight Mind: Turn Off Your Noisy Thoughts and Get a Good Night's Sleep
• End the insomnia struggle: a step-by-step guide to help you get to sleep and stay asleep

Online/app-based CBT-i programs like The Sleep Reset sometimes involve a one-time or monthly fee. Other simple programs like the Mayo Clinic’s CBT-i Learning Module are free.

There are also many sleep and insomnia apps available on the Apple App Store and Google Play Store. Some are free, while others require payment.

Be careful with apps or online programs that:

• Promise a “quick fix” or instant cure
• Only offer things like sounds or meditation, without helping you change your habits or thoughts
• Charge a lot of money but don’t clearly explain what you’re getting
• Make big promises that seem too good to be true

Important: Just having a workbook or app isn’t enough. Do the exercises and track your sleep to get the benefits.