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When poor sleep sticks around: CBT-I

The first-choice treatment for long-term insomnia, and how to get it

Movement & sleep4 min readDeep dive

Written by the Splash teamSources checked

On this page 5 sections
  1. Quick answer
  2. What is CBT-I?
  3. How to get it
  4. What about sleeping tablets and pharmacy sleep aids?
  5. Sources

Quick answer

  • Insomnia that lasts 3 months or more is long-term and treatable.
  • CBT-I is the first-line treatment, ahead of sleeping tablets.
  • Ask your GP about face-to-face or online CBT-I.
  • A sleep and cycle diary helps your appointment.

A few bad nights before your period is common. But if you have struggled to fall asleep, stay asleep or wake too early most nights for weeks or months, it may be insomnia. The NHS says insomnia that lasts less than 3 months is short-term and 3 months or longer is long-term. The good news is that it is treatable without pills.

What is CBT-I?

CBT-I is a short course of cognitive behavioural therapy made for sleep. It helps you change the habits and thoughts that keep you awake. NICE, the body that advises the NHS, lists CBT-I as the first-line treatment for long-term insomnia in adults, so a GP should think of it before sleeping tablets.

26 mins
Less time awake in the night, on average, after CBT-I in a review of 20 trials (1,162 adults). People also fell asleep about 19 minutes fasterSee sources

Trials usually combine several parts: understanding sleep, keeping a sleep diary, a steady wake-up time, going to bed only when sleepy, getting up if you cannot sleep, relaxation, and working on worried thoughts about sleep. No harmful effects were reported in that review.

How to get it

  • Ask your GP. The NHS says you may be offered CBT face to face, or through an online self-help programme.
  • In England you can often self-refer to NHS Talking Therapies if poor sleep is tied up with anxiety or low mood.
  • NICE is currently assessing online CBT-I programmes for NHS use (October 2026). Ask your GP what is available in your area.
  • You may wait a while for face-to-face CBT-I, so the free NHS sleep tips are a good start in the meantime.

Most CBT-I trials involved adults whose insomnia had no other main cause. If your sleep is affected by your cycle, pain, hormones, snoring or a mental health condition, tell your GP, because those may need treating too.

What about sleeping tablets and pharmacy sleep aids?

  • The NHS says GPs now rarely prescribe sleeping pills, because they have serious side effects and you can become dependent. They are only given for a few days or weeks.
  • Pharmacy sleep aids (some with valerian or lavender, others with an antihistamine) may help for 1 to 2 weeks at most. They can make you drowsy, so do not drive. Check with a pharmacist or GP first.
MythInsomnia is just something to live with.
Fact

Long-term insomnia is treatable. CBT-I helps most people, the effects seem to last, and it does not carry the risks of sleeping pills.

Sources

  1. NHS: Insomnia
  2. NICE: Digital cognitive behavioural therapy for insomnia (in development)
  3. Trauer et al. (2015) Cognitive behavioral therapy for chronic insomnia: systematic review and meta-analysis, Annals of Internal Medicine
  4. NHS: Cognitive behavioural therapy (CBT)
  5. NHS: Talking therapies
  6. NHS Every Mind Matters: How to fall asleep faster and sleep better

Written by the Splash teamSources checked

This is general information, not medical advice. Splash can’t diagnose. If you’re worried, talk to a GP, pharmacist or sexual health clinic. In an emergency call 999 (UK) or 911 (US). How we write and check articles.

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