How Long Does CBT-I Take to Work?

Imagine going from 11 or more years with insomnia to falling asleep in 15 minutes. How long it takes CBT-I to work may vary for each person. Here is my experience with cognitive behavior therapy for insomnia (CBT-I) and its timing for success.

How long does it take CBT-I to work?

I'm a qualified sleep therapist who helps adults with their insomnia. I have seen many people recover from long-term insomnia - some with decades of sleeplessness under their belts and twisted into their sheets.

I wanted to share a story with the hope that it will inspire and reassure you that you can find your way through your insomnia.

Initial reactions to CBT-I may feel intimidating

Firstly, it's essential to know that I use cognitive behavioral therapy for insomnia (CBT-I), acceptance and commitment therapy and similar approaches to my work with clients who aren't sleeping well. When you search the interwebs for CBT-I in particular, it's often presented as highly rigid, with strict and often oppressive rules. It's entirely off-putting, to be honest, to read about it in that way. It even makes me cringe!

But the actual interventions can be highly tailored and adapted to help an individual - with their unique sleep needs, ways of learning and levels of sleep-related anxiety. Different people's personalities may mean that different things set them up for success, and approaching it collaboratively can mean a dramatically better improvement in the sense of confidence and, ultimately, sleep.

Strategies often differ

Some people respond well to a more challenging route through, and some need to have adaptations and progress more slowly toward an ideal intervention set for them. Some people do better starting with dealing with the anxiety before asking them to do some interventions.

None of this nuance gets picked up in the rules you read online. That's the trouble with "Dr. Interwebs."

Consider this CBT-I scenario:

Picture someone with insomnia for over 11 years. Maybe someone like you.

Imagine this person had difficulty falling asleep and also waking up too early. It may have taken 2 hours to fall asleep, only to be awake at 4 AM.

With 2 adapted interventions - a minor adjustment to bedtime and a more significant adjustment to a morning routine - this person was falling asleep within 15 minutes and sleeping a bit later.

How long to achieve success with CBT-I?

You might guess that this took a long time to get to after so many years of insomnia.

How long? What's your guess? A year? Three months?

Imagine now that this improvement was achieved in 5 days.

Yes. And this is based on an actual situation.

Timing and simple strategies help

We don't always need to suggest extreme interventions to have a significant impact - just the right amount of the proper intervention at the correct time.

In my experience, helping someone resolve an early awakening can take more time. But imagine that as time went on, this person continued to sleep later and later - getting up closer to the alarm. And that this person had more energy, focus and patience and was less focused on sleep, even before it came closer to their ideal sleeping pattern. That itself was liberating.

Successful sleep therapy

These approaches aren't for everyone, but your sleep specialist could assess if it would be safe for you to try with their help. Don't be put off by the scary black-and-white rigid rules you see on a screen – you may just get lucky and find someone near you who can coach you through your personal version of successful sleep therapy.

Have you ever tried cognitive behavioral therapy for insomnia? Share your experience in this forum.