When Should Someone Consider Cognitive Behavioural Therapy For Insomnia? A Clinical Psychology Podcast Episode.
Over the past few months as I've started new roles, my life has changed in different ways and I have so many new and exciting projects, I do find myself slightly struggling to sleep some nights. In a previous podcast episode on how anxiety and rumination disrupt sleep, I discussed how hyperarousal can disrupt our sleep patterns. Yet on The Psychology World Podcast, we haven't discussed when it might be a good idea for someone who struggles with sleep to consider and reach out to a mental health professional. Therefore, in this clinical psychology podcast episode, you'll learn more about cognitive behavioural therapy for insomnia, when it might be a good idea to consider it and so much more. If you enjoy learning about sleep psychology, how to improve your sleep and mental health, then this will be a great episode for you.
Today's psychology podcast episode has been sponsored by CBT For Anxiety: A Clinical Psychology Introduction for Cognitive Behavioural Therapy for Anxiety. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.
What is Cognitive Behavioural Therapy for Insomnia?
Before we can understand when it might be a good idea for someone to consider cognitive behavioural therapy for insomnia, we need to understand what this therapy actually is. Therefore, cognitive behavioural therapy for insomnia is the gold standard treatment option for insomnia. It is a brief, therapeutic intervention that takes between four and eight sessions on average, and each session lasts for an hour.
As part of the therapy, you keep a sleep diary and this allows the mental health professional to make personalised recommendations to you based on your sleep-wake patterns. As well as throughout the therapy, you learn about important sleep-related topics like relaxation, stimulus control and cognitive flexibility to help you improve your sleep.
In addition, research suggests that cognitive behavioural therapy for insomnia is more effective than hypnotic medications for improving sleep quantity as well as quality, and it has fewer side effects. Also, people typically see improvements continue even after they’ve ended treatment.
Finally, cognitive behavioural therapy for insomnia is so much more than just focusing on sleep hygiene and it can be life-changing for people who suffer from insomnia and poor sleep.
Personally, this is why I wanted to focus on sleep because back in 2025, we spoke about the importance of having a consistent sleep schedule for our mental health. As someone who was struggling with their sleep and mental health, once I started to learn how to improve my sleep then my life started to get better. Now, I want to continue the conversation around how we can improve our sleep to help others since you might be reading or listening to this episode and you might realise that cognitive behavioural therapy for insomnia might help you.
Equally, as aspiring or qualified psychologists, it is never ever a bad thing to improve our knowledge of mental health treatment because we might be talking to a client, a peer or a family member, they mention that they struggle with sleep and after a longer conversation, we realise that maybe it would be a good idea for them to check out this form of psychological therapy.
When Should Someone Consider Cognitive Behavioural Therapy For Insomnia?
I'll never lie to you wonderful readers and listeners, so I have to admit that when looking at the five signs below that it might be a good idea to check out or start cognitive behavioural therapy for insomnia, I do meet some of these signs. Yet the entire point of this podcast episode is to increase our own awareness and be aware of the signs for ourselves, our friends, peers and maybe clients.
I say this because we all know that working in mental health is very tiring, it drains us emotionally and sometimes it can be a very thankless task. You might even have clients or workplace situations that keep you up at night. This is one of the reasons why it's important to know the signs when it might be a good idea to start cognitive behavioural therapy for insomnia. This will allow you to better protect yourself, your mental health and your emotional energy.
If You Spend A Significant Amount Of Time Lying In Bed, Check Out CBT-I
As a result, the first sign that it might be a good idea to start cognitive behavioural therapy for insomnia is if you spend a significant amount of time lying awake in bed each night. This is definitely a major problem that I have from time to time. I think there are some nights when I could easily spend an hour just lying in bed, tossing and turning. And whilst this might sound natural and normal, it isn't good in the slightest. Building upon this, other people are able to get to sleep easily but then they wake up for long periods of time throughout the night, and they struggle to get back to sleep. Both of these situations are not good for our sleep and health.
Therefore, cognitive behavioural therapy for insomnia can be extremely effective at reducing the amount of time that you spend tossing and turning. This has the added benefit of allowing your bed to finally feel like a calming environment again.
Personally, this is why for the past few nights I've been trying to make sure I only turn off my bedroom lights when I go to sleep. I understand that my next statement will probably make sleep experts scream but before I go to bed I make sure that several things are done on my phone, I read on my Kobo Nia, I do my Japanese Duolingo and so on. Yet nowadays, I make sure that the lights are on because I want my brain to start acknowledging that when the lights go off, we don't do anything else except sleep.
Thankfully, it seems to be working and helpful.
Anyway, if you're tossing and turning and struggling to get to sleep and staying asleep, then CBT-I might be a good idea.
If You're Frequently Tired During The Day, Check Out CBT-I
The second sign that it might be a good idea to check out cognitive behavioural therapy for insomnia is if you're frequently tired during the day. This is another sign that I can unfortunately relate to because I do have to be very careful with my sleep as even the smallest changes can "mess" me up for days. The other week, I went out with some friends, had a great time and I didn't go to bed until midnight. I was tired for days. I had a headache and I just didn't feel right.
Even this week, I probably overworked myself on Monday and for the next two days, I was severely tired come mid-morning and that would last all day.
Anyway, whilst some people (who I am seriously jealous of) are actually short sleepers so they need less sleep than the average person to be mentally and physically restored because of their genetic factors, not everyone is like this. The vast majority of people do need at least 7 or more hours of sleep a night depending on their age, otherwise they would get sleepy during the daytime. If this consistently happens to you, then maybe it's a good sign to start CBT-I.
Personally, I think if we apply this sign to clinical work, then this might be us noticing that a client is consistently tired. Of course, this can be "normal" if they're struggling with their mental health because like I mentioned in a past podcast episode, mental health difficulties can cause you to have poor sleep, then poor sleep can make your mental health worse and then it becomes a vicious cycle.
However, I think if a client continues to turn up tired even after the worst of their difficulties have been dealt with, then it might be a useful idea to explore the concept of cognitive behavioural therapy for insomnia with them.
If You Consistently Have Trouble Sleeping, Check Out Cognitive Behavioural Therapy For Insomnia.
The third sign it might be a good idea to start cognitive behavioural therapy for insomnia is if you're consistently struggling to fall asleep. This is because if you have difficulty sleeping or staying asleep for three nights a week or more for a period of at least three months, then you might fit a diagnosis of insomnia disorder. This diagnosis is important to know about because if you have sleep problems despite plenty of opportunities to sleep and your sleep problems are causing you significant emotional impairment or distress then cognitive behavioural therapy for insomnia might be useful.
For example, this sign might have once been useful for me because there was no reason why I should have had sleeping problems. I didn't have a crying baby to look after, I didn't have a medical need or I didn't have a job that caused sleep disruptions. On paper, there was no reason why I shouldn't have been able to sleep. Yet I couldn't. It is in these sorts of situations when cognitive behavioural therapy for insomnia might be useful.
If You've Tried Other Solutions, Cognitive Behavioural Therapy For Insomnia Might Be Useful.
Our penultimate sign that CBT-I might be useful for you is if you've tried many other solutions. For example, I know that people try melatonin tablets or gummies, they try sleepy tea, listening to ASMR or whale music and so on. If you've tried all of these things and more, then CBT-I might be a good idea.
Of course, you might be hesitant to try yet another solution but thankfully cognitive behavioural therapy for insomnia has a strong research basis that supports it as a very effective way to improve sleep.
Personally, I strongly believe that this tip might be a good sign to be aware of for aspiring and qualified mental health professionals because we always need to be aware of how to address psychological resistance in therapy. Since we, and even the client might acknowledge intellectually, that CBT-I is the best thing for them, but they might not want to go through yet another service, yet another professional and yet another series of therapy. This might be especially true if the client believed for whatever reason that you were going to be the person to solve all their difficulties.
Understanding how to deal with psychological resistance is important. You could link it to the client's motivations, their drives and their goals as one example.
If You Want To Significantly Change Your Sleep, CBT-I Might Be That Change
Capacity to change is one of my favourite topics within clinical psychology because it is so true. It doesn't matter how much support, how many techniques and how much therapy you give a person, if they don't want to change then the therapy will be a complete and utter waste of time. It will fail as well.
As a result, all the other signs that it might be a good idea to consider cognitive behavioural therapy for insomnia might be great but they will be useless if you don't want to genuinely change your sleep behaviour. As well as a lot of people think that cognitive behavioural therapy for insomnia simply involves improving your sleep hygiene and that is certainly one aspect, but it isn't everything.
CBT-I involves asking you about making significant changes to your sleep, including how long you spend there and the timing of when you get into bed. As well as since sleep is a biological process and it will take your body weeks to adapt so you can see the full benefit, it will require commitment.
Clinical Psychology Conclusion
Given my own troubled relationship with sleep over the past few years as well as my increased awareness of the link between mental health and sleep quality, this is something that I am really passionate about. Therefore, I have really enjoyed learning more about cognitive behavioural therapy for insomnia, why it’s useful and what the various signs are that it might be good for you.
As a little recap at the end of this episode, here are the key signs that you might benefit from cognitive behavioural therapy for insomnia:
· You spend a significant amount of time lying in bed awake.
· You consistently feel tired during the day.
· You consistently have trouble to fall or stay asleep
· You’ve tried other solutions and your sleep still hasn’t improved.
· You want to make real changes to your sleep behaviour.
I really hope you enjoyed today’s clinical psychology podcast episode.
If you want to learn more, please check out:
CBT For Anxiety: A Clinical Psychology Introduction for Cognitive Behavioural Therapy for Anxiety. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.
Have a great day.
Clinical Psychology References and Further Reading
Altena, E., Ellis, J., Camart, N., Guichard, K., & Bastien, C. (2023). Mechanisms of cognitive behavioural therapy for insomnia. Journal of Sleep Research, 32(6), e13860.
Baglioni, C., Espie, C. A., Altena, E., Gavriloff, D., Jernelöv, S., Holzinger, B., ... & Riemann, D. (2023). Cognitive behavioural therapy for insomnia disorder: Extending the stepped care model. Journal of Sleep Research, 32(6), e14016.
Fleming, M. K., Smejka, T., Macey, E., Luengo‐Fernandez, R., Henry, A. L., Robinson, B., ... & Johansen‐Berg, H. (2024). Improving sleep after stroke: A randomised controlled trial of digital cognitive behavioural therapy for insomnia. Journal of Sleep Research, 33(2), e13971.
https://www.psychologytoday.com/gb/blog/mapping-your-mental-health-journey/202609/5-signs-that-now-is-a-good-time-to-start-cognitive
Sweetman, A., Farrell, S., Wallace, D. M., & Crawford, M. (2023). The effect of cognitive behavioural therapy for insomnia in people with comorbid insomnia and sleep apnoea: A systematic review and meta‐analysis. Journal of Sleep Research, 32(6), e13847.
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