DIAGNOSIS: Insomnia
2015 EST Status: StrongResearch Support (SEE REPORT)Very strong: High-quality evidence that treatment improves symptoms and functional outcomes at post-treatment and follow-up; little risk of harm; requires reasonable amount of resources; effective in non-research settings
Strong: Moderate- to high-quality evidence that treatment improves symptoms OR functional outcomes; not a high risk of harm; reasonable use of resources
Weak: Low or very low-quality evidence that treatment produces clinically meaningful effects on symptoms or functional outcomes; Gains from the treatment may not warrant resources involved
Insufficient Evidence: No meta-analytic study could be identified
Insufficient Evidence: Existing meta-analyses are not of sufficient quality
Treatment pending re-evaluation
1998 EST Status: Strong Research Support
Strong: Support from two well-designed studies conducted by independent investigators.
Modest: Support from one well-designed study or several adequately designed studies.
Controversial: Conflicting results, or claims regarding mechanisms are unsupported.
Strength of Research Support
Empirical Review Status
2015 Criteria
(Tolin et al. Recommendation)
(Tolin et al. Recommendation)
Very Strong
Strong
Weak
Insufficient Evidence
Treatment pending re-evaluation
Find a Therapist specializing in Cognitive Behavioral Therapy for InsomniaList your practice
Brief Summary
- Basic premise: The interaction between cognitive and behavioral factors is the key mechanism involved in the perpetuation of insomnia.
- Essence of therapy: Cognitive-behavioral therapy for insomnia focuses on teaching techniques to modify sleep disruptive behaviors and cognitions that interfere with normal sleep and contribute to insomnia.
- Length: approx. 6 sessions
Treatment Resources
Editors:John Otis, PhD
Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice
Treatment Manuals
Training Resources
Measures, Handouts and Worksheets
Self-help Books
Smartphone Apps
Video Demonstrations
Video Descriptions
Clinical Trials
Meta-Analyses and Systematic Reviews
Other Treatment Resources
Treatment Manuals / Outlines
Treatment Manuals
Books Available for Purchase Through External Sites
- Behavioral Treatments for Sleep Disorders: A Comprehensive Primer of Behavioral Sleep Medicine Interventions (Perlis, Aloia, & Kuhn)
- Overcoming Insomnia: A Cognitive-Behavioral Therapy Approach, Therapist Guide (Treatments That Work; Edinger & Carney)
- Treatment Plans and Interventions for Insomnia: A Case Formulation Approach (Manber & Carney)
Training Materials and Workshops
- Principles and Practice of Sleep Medicine (Kryger, Roth, & Dement; in press)
- Insomnia: A Clinical Guide to Assessment and Treatment (Morin & Espie)
- Etiology of Insomnia (Perlis et al.; in press)
- Cognitive Behavioral Treatment of Insomnia: A Session by Session Guide (Perlis et al.)
- Insomnia: Principles and Management (Szuba, Kloss, & Dinges)
Measures, Handouts and Worksheets
- Sleep Timing Questionnaire (Monk et al.)
- Fatigue Severity Scale (Krupp et al.)
- Consensus Sleep Diary (Carney et al.)
- Epworth Sleepiness Scale (Johns)
- Pittsburgh Sleep Quality Index (Buysse et al.)
- Insomnia Severity Index (Bastien, Vallières, & Morin)
- Dysfunctional Beliefs and Attitudes about Sleep (DBAS-16; Morin, Vallières, & Ivers)
- Sleep Hygiene Index (Mastin, Bryson, & Corwyn)
- The Sleep Condition Indicator (Espie et al.)
Self-help Books
- Quiet Your Mind and Get to Sleep: Solutions to Insomnia for those with Depression, Anxiety, or Chronic Pain (Carney & Manber)
- No More Sleepless Nights (Hauri & Linde)
- Sleeping Through the Night: How Infants, Toddlers, and Their Parents Can Get a Good Night’s Sleep (Mindell)
- Sleepio (an online sleep improvement program; Espie, Kyle, & Sheaves)
Important Note: The books listed above are based on empirically-supported in-person treatments. They have not necessarily been evaluated empirically either by themselves or in conjunction with in-person treatment. We list them as a resource for clinicians who assign them as an adjunct to conducting in-person treatment.
Smartphone Apps
- CBT-i Coach (US Dept of Veterans Affairs)
Clinical Trials
- A randomized controlled trial of cognitive behavioral therapy for insomnia: An effective treatment for comorbid insomnia and depression (Ashworth et al., 2015)
- An open trial of cognitive therapy for chronic insomnia (Harvey et al., 2007)
- Randomized placebo-controlled trial of cognitive behavioral therapy and armodafinil for insomnia after cancer treatment (Roscoe et al., 2015)
Meta-analyses and Systematic Reviews
- Comparative meta-analysis of behavioral interventions for insomnia and their efficacy in middle-aged adults and in older adults 55+ years of age (Irwin, Cole, & Nicassio, 2006)
- Nonpharmacological interventions for insomnia: A meta‐analysis of treatment efficacy (Morin, Culbert, & Schwartz, 1994)
- Identifying effective psychological treatments for insomnia: a meta‐analysis (Murtagh & Greenwood, 1995)
- A meta-analysis on the treatment effectiveness of cognitive behavioral therapy for primary insomnia (Okajima, Komada, & Inoue, 2011)
Other Treatment Resources
- Hyperarousal and insomnia (Bonnet & Arand, 1997)
- A neurobiological model of insomnia (Buysse et al., 2011)
- Cognitive-behavioral therapy for primary insomnia (Edinger & Means, 2005)
- A cognitive model of insomnia (Harvey, 2002)
- Insomnia, psychiatric disorders, and the transdiagnostic perspective (Harvey, 2008)
- The delivery of behavioral sleep medicine to college students (Kloss et al., 2011)
- Sleep patterns and predictors of disturbed sleep in a large population of college students (Lund et al., 2010)
- Nonpharmacologic treatment of chronic insomnia: An American Academy of Sleep Medicine review (Morin et al., 1999)
- Chronic insomnia (Morin & Benca, 2012)
- Self-reported sleep disturbance as a prodromal symptom in recurrent depression (Perlis et al., 1997)
- The hyperarousal model of insomnia: A review of the concept and its evidence (Riemann et al., 2010)
- Clinical guideline for the evaluation and management of chronic insomnia in adults (Schutte-Rodin et al., 2008)
- Who is a candidate for cognitive-behavioral therapy for insomnia? (Smith & Perlis, 2006)
- A behavioral perspective on insomnia treatment (Spielman, Caruso, & Glovinsky, 1987)