Sleepless nights starting to take their toll? We explain more about how talk therapy could be the answer to help you get a better night’s sleep

Sleep. It’s easy to forget how huge an impact sleep has on, well, everything. From our physical to mental health, sleep is vital for us to give our bodies and brains the time to rest, repair, restore, and process information. Sleep supports a healthy immune system, helps us be more resilient, improves mood and memory, helps us concentrate, and even regulates our appetite. Without enough sleep, we’re at a significantly higher risk of developing serious health issues – physically and mentally. So, it’s no surprise that worrying about sleep is such a common problem.

According to the NHS, around one in three of us in the UK are affected by sleep problems. While most adults need somewhere between seven to nine hours each night, around one in five of us don’t get enough sleep. If you have difficulty falling or staying asleep, or find yourself experiencing poor-quality sleep (meaning you feel tired the next day), it could be a sign of insomnia. While the exact figures aren’t known, it’s thought that around a third of us in the UK experience insomnia, thanks to common causes like stress, anxiety, depression, noise, uncomfortable sleeping conditions (too hot, cold, uncomfortable), shift work, too much caffeine, alcohol, or smoking. 

We’ve all heard the same suggestions when it comes to trying to get a better night’s sleep: change your screen habits before bed, try to relax and put daily stresses out of your mind, and avoid late-night food and caffeine. But what if you’re struggling to make sustainable changes by yourself? Or what if moving past the surface-level suggestions is proving more challenging than you expected? This is where therapy could help.

What is the best therapy for insomnia?

Different kinds of therapy can be recommended for sleep problems, including insomnia. It can be helpful to keep a sleep diary before trying therapy, as this can help you and your therapist to identify patterns and spot unhelpful sleep habits that you might not be aware of. The Sleep Charity recommends keeping a diary for two weeks before speaking with your GP or healthcare professional. If you are worried that your sleep is starting to affect your daily life or how well you can look after yourself, it could be worth talking with your GP to explore any other possible underlying health conditions that might be affecting you and causing sleep problems. 

Working with an experienced sleep counsellor or therapist can help you to recognise and change unhelpful thoughts and behaviours that could be keeping you awake at night, or affecting your ability to peacefully fall asleep. A therapist can also recommend further self-help tools and routines to help support you and improve your sleep habits.

While there are different kinds of therapy that can help with different kinds of sleep problems, one type of therapy is particularly recommended: CBT-I.

What is CBT-I?

Cognitive behavioural therapy for insomnia (CBT-I) is recommended by the National Institute for Health and Care Excellence (NICE) for those with long-term insomnia. An evidence-based approach, CBT-I is scientifically proven to help treat chronic insomnia. It is recommended as a first line of treatment for adults with long-term insomnia as an effective alternative to medication. But what does CBT-I involve, and how can you find a therapist who offers CBT-I?

CBT-I is a kind of cognitive behaviour therapy, focused on helping you restructure thoughts, feelings, and behaviours that may be affecting how you sleep. Combining techniques like relaxation training, sleep restriction, and stimulus control, CBT-I can help with both short-term and chronic insomnia in a relatively short space of time. 

Typically lasting six to eight sessions, a CBT-I practitioner helps you to examine your thoughts and feelings about sleep, challenges unhelpful or inaccurate thoughts about sleep, helps you learn to relax and limit stimulus before bed, and can help you to learn more about the connections between your behaviour, thoughts, feelings, and sleep.

So, for example, if you have experienced insomnia for some time, you might find yourself feeling more and more anxious before falling asleep. You know you need to get a good night’s sleep to be ready for work the next day or to cope with family life, but you’re dreading lying awake for hours. That can create a cycle of unhelpful thoughts – worrying that you aren’t going to sleep, so subconsciously setting yourself up for an even more difficult time falling asleep – that you might not even be aware of. Therapy can help you to identify these patterns, challenge these unhelpful thoughts and behaviours, and find new, more helpful ones to replace them. 

How is CBT-I different from self-help and good sleep hygiene?

But what’s the difference between CBT-I and good sleep hygiene? Psychotherapist Donna West, MBACP (Accred) ACTO (Snr), explains more. “While both CBT-I and sleep hygiene aim to improve sleep, they differ in their approach and scope. Sleep hygiene primarily focuses on optimising environmental and behavioural factors that promote sleep, such as maintaining a comfortable sleep environment and establishing a consistent bedtime routine.

“In contrast, CBT-I goes beyond surface-level recommendations by addressing the underlying cognitive and behavioural patterns contributing to insomnia. It offers structured techniques to challenge negative thought patterns, modify behaviours, and foster long-term improvements in sleep quality.”

Six simple ways CBT-I helps you to get a better night’s sleep

So now that we know more about CBT-I, how exactly can it help you get a better night's sleep? Here are six ways it can help:

  1. Identifying and challenging negative thoughts. A CBT-I therapist can help you spot and reframe thoughts that are keeping you up at night. So instead of thinking ‘I’m going to have another sleepless night,’ it might become ‘One rough night doesn’t mean every night will be the same. Even if sleep doesn’t come right away, I can focus on being calm and relaxed.’ 
  2. Reducing worry before sleep. Through talking through sleep-related anxiety, CBT-I can help you create a sense of calm. Talking about things that make us feel anxious provides a feeling of emotional release and helps us to gain perspective about our worries, taking some of the power away from those anxious or negative thoughts that have been building. 
  3. Restricting bed time to sleep time. Sleep restriction is all about limiting how much time you spend in bed to try and make your sleep more efficient. This, over time, can help train your body and mind to associate your bed with sleep again, rather than feelings of frustration, anxiety, or wakefulness that might have taken over.
  4. Encouraging you to get up if you’re not sleepy. Along with limiting time in your bed to match your sleep time, CBT-I encourages stimulus control. This means going to bed when you feel sleepy, and getting up out of bed if you are awake for more than a short period of time. This can help you to reestablish the link between being in bed and sleeping, and helps avoid creating new feelings of frustration around sleep and your bed. 
  5. Reinforce good sleep hygiene. Sleep hygiene is all about creating healthy sleep habits like having a regular sleep schedule, avoiding stimulants before bed, and creating a comfortable, relaxing sleep environment. A therapist can teach you all about how to practice good sleep hygiene.
  6. Introduce helpful relaxation techniques. Deep breathing exercises and simple relaxation techniques like progressive muscle relaxation can help you manage anxiety and prepare yourself physically and mentally for sleep. Psychotherapist Thomas Hatton, MSc, BACP, shares simple mindfulness techniques that you can try at home to help calm your mind and body.

If sleepless nights have left you feeling stuck, remember: you don’t have to figure it all out alone. Therapy offers a safe, supportive space to explore what’s keeping you awake and to discover practical tools for lasting change. If you’re ready to reclaim your nights (and your energy), reaching out to a therapist who specialises in sleep issues could be just the start you’re looking for.

Ready to sleep more easily? Find a therapist trained in cognitive behavioural therapy for insomnia (CBT-I) and start your journey to better rest today.