The treatment
Insomnia & Cognitive Behavioural Therapy
CBT-I is the first-line treatment for chronic insomnia in international clinical guidelines — ahead of medication, with results that hold after treatment ends.
What it is
A mind that will not slow down at the moment it needs to.
Insomnia is not simply «not many hours of sleep». It is the persistent difficulty in falling or staying asleep, despite conditions that allow it, with a clear cost the next day. That last part is decisive: someone who sleeps five hours and functions well does not have insomnia.
In its acute form it lasts days to weeks and usually resolves on its own; 30–40% of the population experience it within any given year. It becomes chronic when it occurs at least three nights a week for more than three months — and that affects 8–10% of the population.
It is more common in women, particularly after menopause. And it often conceals another disorder underneath: sleep apnoea, for instance, frequently presents as sleep-maintenance insomnia.
The three forms
Difficulty falling asleep
You consistently need more than 20–30 minutes to fall asleep.
Difficulty staying asleep
You wake during the night and struggle to get back to sleep.
Early final awakening
You wake 20–30 minutes or more before your time, with no return to sleep.
The mechanism
Why insomnia persists long after its cause has passed.
A stressful event disrupts sleep. So far, normal — that is how the body responds.
The reasonable moves begin: earlier to bed, staying there awake, daytime naps, coffee, clock-watching.
The bed is now associated with being awake rather than with sleep. Insomnia no longer needs the original cause to keep going.
CBT-I targets exactly those maintaining factors. It does not teach you to sleep — it removes what stops sleep from doing what it already knows how to do.
The components
What the treatment actually involves
Sleep restriction
The most powerful component of the treatment. We temporarily compress the time you spend in bed so that it matches the time you actually sleep. Sleep becomes denser and continuous, and is then gradually extended.
Stimulus control
In chronic insomnia the bed has become associated with being awake, not with sleep. With specific rules we reconnect the bed with sleep alone, so that sleepiness appears where it should.
Cognitive restructuring
We work on the thoughts that sustain the fear of the night — «if I don't get eight hours I'll fall apart», «something must be wrong with my body». Catastrophising about sleep is itself a cause of insomnia.
Arousal reduction
Techniques that lower physical and mental hyperarousal: progressive muscle relaxation, diaphragmatic breathing, a structured worry time earlier in the day.
Relapse prevention
You leave with a protocol: what to do when a bad week comes, so that one episode does not turn back into a chronic problem. This is what makes the results of CBT-I last.
The cost during the day
Insomnia does not end in the morning.
- Fatigue that does not lift with rest
- Difficulty with concentration and memory
- Irritability and mood swings
- Anxiety about the coming night
- Reduced performance at work
- Strain on relationships
The course
What to expect
- Week 1
A detailed sleep history, psychometric assessment and a sleep diary. Nothing changes yet — first we measure.
- Weeks 2–3
Sleep restriction and stimulus control begin. This is the most demanding stretch, and where the outcome is decided.
- Weeks 4–6
Sleep becomes denser and is gradually extended. In parallel we work on thoughts and hyperarousal.
- Completion
Consolidation and a relapse-prevention plan: what you do on your own when a difficult stretch comes.
Not sure whether what you are living with is insomnia?
Take the test