Cognitive Behavioural Therapy for Insomnia (CBT-I)

Structured multi-session psychological treatment for chronic insomnia addressing the thoughts and behaviours that perpetuate poor sleep, delivered by the clinic's mental health team as part of its integrated sleep management programme.

Cognitive Behavioural Therapy for Insomnia (CBT-I) is the internationally recognised first-line treatment for chronic insomnia disorder, recommended ahead of sleep medication by clinical guidelines from the American Academy of Sleep Medicine and the European Sleep Research Society. At Nuffield Sleep, CBT-I is delivered by the clinic's mental health practitioners as part of the multidisciplinary care model, ensuring that patients with comorbid medical causes of poor sleep receive coordinated treatment rather than siloed psychological care. The programme typically spans four to eight structured sessions and draws on several evidence-based components. Sleep restriction therapy involves temporarily limiting time in bed to match actual sleep duration, creating mild sleep pressure that consolidates fragmented sleep and rebuilds sleep drive. Stimulus control reestablishes the bedroom as a cue for sleep rather than wakefulness, addressing the conditioned arousal that commonly maintains chronic insomnia. Cognitive restructuring identifies and reframes unhelpful beliefs about sleep — catastrophising about consequences of poor sleep, perfectionism around sleep targets — that generate the pre-sleep anxiety fuelling the insomnia cycle. Sleep hygiene education covers circadian rhythm alignment, light exposure management, caffeine and alcohol timing, and physical activity scheduling. Relaxation techniques, including progressive muscle relaxation and diaphragmatic breathing, are introduced to reduce physiological arousal at bedtime. As part of Nuffield Sleep's multidisciplinary approach, CBT-I delivery is co-ordinated with any medical treatment (e.g., CPAP for sleep apnoea) and nutritional interventions, so that psychological and physical contributors to insomnia are addressed simultaneously.