CBT-I and psychological treatment for insomnia, broken sleep, night terrors and the anxiety that keeps you awake — the approach clinical guidelines recommend before sleeping tablets.
Most people with insomnia are not short of sleep advice. They have already tried the dark room, the cold room, the no-phone rule and the magnesium. What keeps insomnia going is rarely a missing tip — it is the effort itself: trying harder to sleep is reliably one of the things that prevents it.
Cognitive behavioural therapy for insomnia (CBT-I) targets that directly, and it is recommended as first-line treatment ahead of sleeping medication in Australian and international guidelines. It is also uncomfortable at the start, because the first move is usually spending less time in bed, not more.
Related approaches and areas: anxiety, CBT, mindfulness-based approaches.
Medicare rebates available with a GP Mental Health Care Plan. In person in Bella Vista or by telehealth across NSW.
The first step is a sleep diary, not an intervention. What people believe about their sleep and what their sleep actually does diverge often enough that treating the belief would be treating the wrong thing.
Counter-intuitively, spending LESS time in bed is the most powerful component. It rebuilds the association between bed and sleep. It is also the hardest part, and it is explained fully before it is asked of you.
Re-establishing bed as a place for sleep rather than for lying awake problem-solving. Simple to describe, demanding to apply consistently.
Catastrophic predictions about tomorrow are part of what sustains the arousal. Cognitive work addresses them, and mindfulness-based approaches can reduce the pre-sleep effort that makes sleep harder.
Guidelines recommend CBT-I as first-line treatment for chronic insomnia, and its benefits tend to persist after treatment ends, whereas medication works while it is taken. Decisions about medication belong with your GP; the two are not mutually exclusive.
Most courses run 4–8 sessions. Sleep often gets slightly worse in the first week or two of sleep restriction before it improves, which is expected rather than a sign it is failing.
Not usually. Where snoring, witnessed pauses in breathing or significant daytime sleepiness suggest sleep apnoea, we will refer you back to your GP first — CBT-I does not treat apnoea, and treating the wrong thing wastes months.
Yes. Adolescent sleep has its own biology, including a genuine shift in body clock, so the approach differs from adult insomnia rather than being a smaller version of it.
Eligible clients can claim rebates with a GP Mental Health Care Plan, covering up to 10 sessions per calendar year.
Medicare rebates available with a GP Mental Health Care Plan. In person in Bella Vista or by telehealth across NSW.