If you struggle to fall asleep, stay asleep, or wake up feeling unrefreshed, sleep therapy such as Cognitive Behavioural Therapy for Insomnia (CBT-I) may be part of the solution.
Insomnia is increasingly common across Asia, where long working hours, high stress levels, and heavy screen use often spill into the night. In Singapore, studies suggest that up to one in three adults experience insufficient or poor-quality sleep, while surveys in Malaysia and other parts of Southeast Asia consistently report high rates of sleep deprivation among working adults. Despite this, many people still rely on sleeping pills or simply “push through” fatigue, rather than addressing the underlying causes of poor sleep.
CBT-I is a structured, evidence-based form of sleep therapy that focuses on changing the thoughts and behaviours that keep insomnia going. Unlike medication, it targets the root of sleep problems and is now widely recommended as a first-line treatment for chronic insomnia by international and regional sleep experts.
What Is CBT-I?
CBT-I is a structured, short-term sleep therapy designed to treat insomnia by addressing its root causes.
Rather than forcing sleep or simply managing symptoms, CBT-I helps you:
- Identify unhelpful thoughts about sleep
- Change behaviours that interfere with restful sleep
- Rebuild a healthier relationship with bedtime and the bed
CBT-I is backed by strong scientific evidence and is effective for both short-term and chronic insomnia.
How CBT-I Works
CBT-I looks at the close connection between how we think, what we do, and how we sleep.
At the start of therapy, you may be asked to complete an intake assessment, and keep a sleep diary for 1–2 weeks. This helps the therapist understand your sleep patterns, habits, and triggers. Based on this information, specific strategies are selected to improve sleep quality over time.
Treatment usually lasts 6 to 8 sessions, though this may vary depending on individual needs.
Key Components of CBT-I
CBT-I typically combines several techniques. Not everyone needs all of them, your therapist tailors the approach to you.
1. Cognitive Therapy
This component focuses on identifying and reframing unhelpful thoughts about sleep, such as:
“If I don’t sleep tonight, tomorrow will be a disaster”
“I must get 8 hours or I won’t function”
These thoughts increase emotional distress and make sleep harder. CBT-I teaches more balanced, realistic ways of thinking that reduce pressure around sleep.
2. Stimulus Control
Many people with insomnia start to associate their bed with frustration and wakefulness.
Stimulus control helps retrain the brain by:
- Using the bed only for sleep (and sex)
- Getting out of bed if you can’t fall asleep within a short time
- Returning to bed only when sleepy
- Waking up at the same time every day
Over time, the bed becomes a cue for sleep again and not stress.
3. Sleep Restriction or Sleep Compression
People with insomnia often spend long hours in bed awake. Sleep restriction temporarily reduces time in bed to match actual sleep time, increasing sleep drive and efficiency.
As sleep becomes more consolidated:
- Time in bed is gradually increased
- Sleep becomes deeper and more consistent
Sleep compression is a gentler version often used for older adults.
4. Relaxation Techniques
CBT-I includes relaxation strategies to calm the body and mind before sleep, such as:
- Slow, deep breathing
- Progressive muscle relaxation
- Guided imagery or mindfulness
These techniques reduce physical tension and racing thoughts that commonly keep people awake.
5. Sleep Hygiene and Education
Education is a core part of CBT-I. This includes guidance on:
- Keeping a consistent sleep schedule
- Avoiding caffeine, alcohol, and heavy meals close to bedtime
- Creating a dark, quiet, and comfortable sleep environment
- Establishing a regular wind-down routine
Homework between sessions, such as sleep diaries or practising techniques, is common and helps reinforce progress.
Read also: Mastering Sleep Hygiene For Quality Sleep
CBT-I vs Sleeping Pills
Sleeping pills may provide short-term relief, especially during periods of acute stress. However, they:
- Do not address the underlying causes of insomnia
- May cause side effects such as dependence, grogginess, or memory issues
- Are generally not recommended for long-term use
CBT-I, on the other hand:
- Treats the root causes of insomnia
- Has lasting benefits even after therapy ends
- Has no known harmful side effects
In some cases, medication and CBT-I may be used together under medical supervision.
Read also: What Your Brain Does When You Take Sleeping Pills
Who Can Benefit from CBT-I?
CBT-I can help people with insomnia related to:
- Stress or lifestyle habits
- Anxiety or depression
- Chronic medical conditions
- Shift work or irregular schedules
- Pregnancy or post-cancer treatment sleep difficulties
Studies show that 70–80% of people who undergo CBT-I experience meaningful improvements in sleep, including falling asleep faster, sleeping longer, and waking less often at night.
Key Takeaway
CBT-I is an evidence-based sleep therapy that treats insomnia by changing the thoughts and behaviours that disrupt sleep. Rather than forcing sleep or relying on medication, it helps retrain the mind and body to sleep more naturally.
For people struggling with ongoing sleep problems, CBT-I offers a safe, effective, and long-lasting path toward better rest.
Struggling with your sleep and want clearer answers? Explore our Sleep page for practical guidance, medical insights, and real questions people ask about sleep.
You can also take our Sleep Quiz to see how your sleep habits measure up.
References
- Trauer, J. M., Qian, M. Y., Doyle, J. S., Rajaratnam, S. M., & Cunnington, D. (2015). Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis. Annals of internal medicine, 163(3), 191–204. https://www.acpjournals.org/doi/10.7326/M14-2841
- Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., Denberg, T. D., & Clinical Guidelines Committee of the American College of Physicians (2016). Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians. Annals of internal medicine, 165(2), 125–133. http://annals.org/article.aspx?doi=10.7326/M15-2175
- Johnson, J. A., Rash, J. A., Campbell, T. S., Savard, J., Gehrman, P. R., Perlis, M., Carlson, L. E., & Garland, S. N. (2016). A systematic review and meta-analysis of randomized controlled trials of cognitive behavior therapy for insomnia (CBT-I) in cancer survivors. Sleep medicine reviews, 27, 20–28. https://linkinghub.elsevier.com/retrieve/pii/S1087079215000921
