Each session typically has a specific agenda (e.g., evaluation, rationale, delivery of individual interventions, adherence management, relapse prevention, etc.). Standard treatment is delivered over the course of six to eight sessions (session length may vary between 30 and 90 minutes). ĬBT-I is a multi-component treatment for insomnia that targets difficulties with initiating and/or maintaining sleep. For more information related to behavioral interventions for pediatric insomnia, please refer to a prior review and meta-analysis. Please note that while sleep problems and symptoms of insomnia are common in children and adolescents, the present paper focuses on the application of CBT-I in adult populations. In the context of Cognitive Behavioral Therapy for Insomnia (CBT-I), it is these perpetuating factors that are the primary focus of treatment. This is thought to be the case because other factors serve to perpetuate insomnia over time (e.g., going to bed earlier to compensate for sleep loss, worrying about daytime functioning). One noteworthy aspect of this model is that insomnia can be maintained long after the life stressor or precipitating event has resolved. A session-by-session outline is also provided.Īccording to the three-factor (3P) model of insomnia, there are three primary factors that contribute to the development of chronic insomnia: (1) predisposing factors - traits or conditions (e.g., high emotional reactivity) that increase one’s vulnerability to developing insomnia (2) precipitating factors - situational conditions (e.g., stressful life events) that trigger the onset of insomnia and (3) perpetuating factors - behaviors and cognitions that contribute to the transition from acute to chronic insomnia and maintain the disorder long term. Core components of CBT-I (i.e., Sleep Restriction Therapy, Stimulus Control Therapy, Sleep Hygiene, and Cognitive Therapy), relapse prevention strategies, multicultural considerations, adjuvants to traditional interventions, treatment adherence issues, efficacy, and further training options are described. The primary goal of this article is to provide a primer or brief introduction to CBT-I that is intended to be accessible to all clinicians and researchers, including non-sleep experts. This is particularly surprising given its large evidence base and recent recommendation as the first line intervention for insomnia. Despite its prevalence and morbidity, the widespread dissemination of CBT-I is not commensurate with insomnia’s overall public health impact. Chronic insomnia is the most prevalent sleep disorder, occurring in approximately 6–10% of the population, and is a risk factor for multiple medical and psychiatric disorders. The primary focus of CBT-I is to address the perpetuating factors (according to the three-factor model of insomnia) that contribute to the development of chronic insomnia. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a multi-component treatment for insomnia that targets difficulties with initiating and/or maintaining sleep and is delivered over the course of six to eight sessions.
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