CBT for Insomnia (CBT-i): How to Fix Sleep without Medication
Sleep is one of the most overlooked but critical factors in both mental health and eating behaviours.
In New Zealand, insomnia is common. Research suggests that around 30–35% of adults experience insomnia symptoms, with a smaller percentage experiencing chronic insomnia that significantly impacts daily functioning. Insomnia is more than just “not sleeping well.” It often involves:
Difficulty falling asleep
Waking during the night
Waking too early and not being able to get back to sleep
Feeling unrefreshed despite spending enough time in bed
Over time, insomnia becomes a cycle. The more you struggle with sleep, the more your mind and body begin to associate the bed with wakefulness, frustration, or anxiety. This is why it can persist even when you’re exhausted and despite your best efforts to get a good' night’s sleep the following evening.
In my opinion, the importance of sleep is under-rated. It is the absolute foundation your brain relies on to regulate mood, improve memory, appetite regulation, alertness and productivity during the day, immune function and decision-making. When sleep is disrupted, everything feels harder, and maladaptive patterns around food can quickly become more intense and more difficult to manage.
Many people don’t realise that their struggles with food are being amplified by chronic exhaustion and disrupted sleep. What can look like “lack of control” is often a nervous system that is overwhelmed, under-resourced and in fight-flight-freeze mode.
How is Insomnia Treated?
CBT-i (Cognitive Behavioural Therapy for Insomnia) is the gold standard, evidence-based treatment for insomnia. It is structured, practical, and highly effective'; often more effective than medication in the long term (when applied consistently and correctly). Rather than just focusing on sleep hygiene, CBT-i addresses the underlying factors that maintain insomnia, including:
Unhelpful sleep habits
Anxiety about sleep
Conditioned wakefulness (your brain associating bed with being awake)
Irregular sleep patterns
Caution: CBT-i is not a quick fix or generic sleep hygiene advice. It needs to be applied correctly, following protocol for it to work. But you can rest assured that it does work, backed up by numerous studies. It is a structured, personalised approach that targets the specific factors that keeps your insomnia going.
How CBT-i works
CBT-i typically includes the following key components:
Sleep Scheduling
You’ll establish a consistent sleep-wake pattern that strengthens your body’s internal clock. This helps regulate when you feel sleepy and when you feel alert.
Sleep Restriction Therapy
This evidence-based strategy reduces time spent in bed to match actual sleep time, which increases sleep pressure and improves sleep quality. While it can feel counterintuitive at first, it is one of the most effective components of CBT-i.
Bed Equals Sleep Therapy
Retraining your brain to associate bed with sleep.
Cognitive Strategies
You’ll learn how to work with racing thoughts, worry, and unhelpful beliefs about sleep (e.g. “I won’t cope tomorrow if I don’t sleep”). These thoughts often increase anxiety and keep the nervous system activated.
Relaxation Therapy
Relaxation and wind-down strategies help shift your body out of a heightened state of alertness, making sleep more accessible. These strategies are also effective for awakenings through the night.
Healthy Sleep Practices
Education on ways to reduce risk factors to prevent future vulnerability (similar to Sleep Hygiene).
Together, these strategies help reduce the time you spend lying awake, rebuild trust in your ability to sleep, and create a more consistent and restorative sleep pattern. While some of the strategies can feel counterintuitive at first, they are highly effective when applied in a structured and supported way. CBT-i helps you to become your own sleep expert, leaving you with practical and sustainable tools that you can keep using after therapy, and when you are at risk of a relapse.
How Sleep Impacts Eating
I decided to upskill and provide CBT-i to clients because I saw time and time again, how poor sleep was interfering with eating disorder therapy. That’s because poor sleep doesn’t just affect energy the next day. It directly impacts your relationship with food. When you’re sleep-deprived, your brain shifts into a more reactive state. This means you’re more likely to seek quick relief, comfort, energy or stimulation through food. Your ability to pause, reflect, and respond intentionally is significantly reduced. You may be more irritable, anxious or low in mood, which further exacerbates the urge to seek relief or comfort in food.
When sleep is disrupted:
Hunger hormones become dysregulated (increased hunger, less satiety)
Cravings for high-energy foods increase
Emotional regulation decreases
Impulse control is reduced
Stress and anxiety are heightened
Your usual strategies just don’t seem to “work”
The emotional centres of the brain become more active, while the parts responsible for decision-making and impulse control become less effective.
Urges feel stronger
“All-or-nothing” thinking increases
Emotional eating becomes more likely
You can have all the “right tools,” but if you’re exhausted, it can be the reason why you are stuck in the cycle of disordered eating. Once sleep is improved, therapeutic work becomes more effective.
How Food Freedom Coach works
I take an integrated approach, recognising that sleep and eating behaviours influence and reinforce each other.
In our work together, we start by building a clear understanding of your current sleep patterns, eating behaviours, and the underlying factors connecting them. This allows us to create a plan that feels personalised, realistic, and achievable.
Using CBT-i, I will guide you step-by-step through evidence-based strategies to improve your sleep. We work collaboratively to implement changes in a way that feels manageable and supportive, adjusting as needed along the way.
As your sleep begins to improve, we then leverage that increased capacity to support your relationship with food. Clients often find that once they are better rested, they feel more in control around eating, more emotionally regulated, and more able to engage in the deeper therapeutic work.
This is where we can integrate eating disorder support, whether that’s reducing binge eating, normalising eating patterns, or addressing food avoidance and anxiety to heal your relationship with food and your body. With improved sleep, these changes become more accessible and more sustainable.
Reach out
If you’ve been feeling stuck in cycles of exhaustion, sleep deprivation, emotional overwhelm, and difficult eating patterns, addressing sleep can be a powerful and often overlooked starting point. CBT-i offers a structured, effective way to improve sleep, and when combined with eating disorder support, it can create meaningful, lasting change.
You don’t have to tackle everything at once. Sometimes, improving sleep is the first step that makes everything else feel possible.
Reach out now for a free 20 minute phone consultation to see how Food Freedom Coach can support you towards complete freedom.
