Insomnia is one of the most common sleep disorders, yet it is often misunderstood. Many people assume sleepless nights are simply the result of stress or a busy mind, but insomnia can appear suddenly, especially during life transitions, and quickly become chronic.
Despite its prevalence, Cognitive Behavioral Therapy for Insomnia (CBT-I)—the gold-standard, evidence-based treatment—is often overlooked in favor of generic sleep hygiene tips or short-term medications.
Life Transitions and Insomnia
Insomnia often emerges during periods of change, both positive and negative. Common triggers include:
Major life events: moving, starting a new job, retirement, or divorce
Health changes: chronic pain, illness, or surgery
Emotional stressors: grief, caregiving, financial strain
Exciting transitions: marriage, parenthood, or career promotions
Even happy changes can create heightened arousal and racing thoughts that disrupt sleep. What begins as temporary sleep loss can develop into persistent insomnia if unaddressed.
Sleep Hygiene vs CBT-I
Many people first try sleep hygiene, which includes:
Limiting caffeine and alcohol before bed
Avoiding screens in the bedroom
Maintaining a cool, dark sleep environment
Keeping a consistent sleep schedule
While these strategies are helpful, sleep hygiene alone rarely resolves chronic insomnia. It addresses lifestyle factors but does not change the learned patterns of wakefulness or anxious thoughts that perpetuate insomnia.
CBT-I, in contrast, is a structured, evidence-based therapy designed to retrain both mind and body. It goes beyond environmental tweaks to target the root causes of insomnia:
Sleep restriction: Limiting time in bed to match actual sleep, then gradually expanding as sleep efficiency improves
Stimulus control: Strengthening the association between bed and sleep by leaving the bedroom if unable to fall asleep
Cognitive restructuring: Addressing anxious or racing thoughts about sleep
Relaxation and mindfulness: Teaching the body to wind down naturally
Unlike sleep hygiene or medication, CBT-I produces lasting improvements and reduces the risk of relapse.
Why CBT-I Is Overlooked
Despite strong evidence, CBT-I remains underutilized:
Low awareness: Many patients—and some providers—don’t know CBT-I exists
Access barriers: Few clinicians are trained in CBT-I, creating long waitlists
Quick-fix culture: People often prefer medications, which offer immediate but short-term relief
Misconceptions: Patients may believe sleep hygiene alone is enough, not realizing CBT-I is a separate, more effective therapy
Steps to Address Insomnia
If you’re struggling with sleepless nights, especially after a life transition:
Recognize the difference: Sleep hygiene supports healthy sleep habits; CBT-I treats chronic insomnia.
Maintain consistent wake times: Even after a poor night, getting up at the same time helps reset your body clock.
Limit time in bed awake: Leave the bedroom if unable to sleep for 15–20 minutes and engage in a calming activity.
Seek specialized help: Look for therapists trained in CBT-I or evidence-based digital programs.
Moving Forward
Sleep is foundational for mental and physical health. While sleep hygiene is useful, it is not a cure for chronic insomnia. CBT-I is the most effective, evidence-based approach, helping you restore restorative sleep, regulate mood, and build resilience during life transitions.
