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

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).

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.

Cognitive Behavioural Therapy for Insomnia (CBT-i) is widely recognised as a highly effective treatment for chronic insomnia. It is recommended as the first-line intervention, meaning it is the preferred treatment before medication.

Research, including large systematic reviews and meta-analyses, shows that CBT-i leads to:

• Moderate to large improvements in time taken to fall asleep

• Moderate to large reductions in night-time waking (and improved ability to return to sleep)

• Moderate to large improvements in overall sleep quality

• Small to moderate increases in total sleep time

In addition to improving sleep, CBT-i has been shown to:

• Improve daytime functioning

• Reduce fatigue

• Support symptoms of co-occurring mental health conditions

• Enhance overall quality of life

Treatment is usually 5-6 sessions, spread over 8 weeks. Although it may be longer for more complex presentations or if there are other physical and mental health conditions that need to be addressed. Similarly, treatment may be completed in 6 weeks if the problem is relatively straight forward. The great thing about CBT-i is that it leaves you with the tools and skills to deal with relapses in sleep.

Yes - CBT-i can be delivered effectively via online video sessions (telehealth).

Research shows that online CBT-i is as effective as in-person treatment, and in some cases may even lead to slightly better outcomes.

Online sessions offer flexibility and convenience, making it easier to access support:

• No travel time, traffic, or parking

• Sessions can fit around work schedules

• Ideal for parents or those needing to stay at home

• Accessible from anywhere in New Zealand

In practice, online CBT-i follows the same structured, evidence-based approach as face-to-face therapy, with the added benefit of being easier to integrate into daily life.