What is CBT-i and how does it work?

CBT-i (Cognitive Behavioural Therapy for Insomnia) is a structured, evidence-based therapy designed to treat chronic sleep difficulties. It works by identifying and changing thoughts and behaviours that disrupt sleep, helping you develop a healthier sleep routine without relying on medication.

How many CBT-i sessions will I need?

Most people see significant improvement in sleep within 4 to 8 sessions. However, the exact number can vary depending on your individual needs, lifestyle, and the severity of the insomnia.

Is CBT-i effective for long-term insomnia?

Yes, CBT-i is considered the gold standard treatment for chronic insomnia and is more effective long-term than sleeping pills. It helps treat the root causes of insomnia rather than just the symptoms.

Can CBT-i help if my sleep problems are linked to anxiety or stress?

Absolutely. CBT-i can be tailored to address underlying stress, anxiety, or racing thoughts, which are often key drivers of sleep issues. It’s common for our psychologists to integrate elements of anxiety treatment into your CBT-i plan.

Do I need a diagnosis to start CBT-i?

No formal diagnosis is needed. If you’re having trouble falling asleep, staying asleep, or waking too early, you may benefit from CBT-i. Many clients seek help before their sleep issues become severe.

Is CBT-i available online?

Yes. We offer CBT-i both in-person and online, making it accessible whether you live in London or prefer remote therapy. Online sessions follow the same structure and are equally effective.

Cognitive Behavioural therapy for Insomnia

Cognitive Behavioural Therapy for Insomnia, often called CBT-i, is a practical, evidence-based therapy that helps you understand and change the patterns that keep sleep problems going. It can be especially helpful when you are struggling to fall asleep, waking during the night, waking too early, or feeling anxious about sleep.

Many sleep difficulties are maintained not just by the original trigger, but by the patterns that build around it. You might spend more time in bed trying to catch up on sleep, worry about how you will cope the next day, check the time during the night, avoid activities because you feel exhausted, or feel increasingly tense as bedtime approaches.

At Hampstead Psychology, we offer CBT-i in Hampstead, London, and online across the UK and internationally. We help you understand what is maintaining the sleep difficulty and work in a focused, collaborative way to rebuild a healthier relationship with sleep.

This page is for information and does not replace a clinical assessment, diagnosis, or medical advice.

When CBT-i might be helpful

You might recognise some of these experiences:

You struggle to fall asleep, even when you feel tired.
You wake during the night and find it hard to get back to sleep.
You wake too early and cannot return to sleep.
You feel anxious, frustrated or tense around bedtime.
You spend a lot of time worrying about how much sleep you will get.
You check the time during the night or calculate how many hours are left.
You feel caught in a cycle of poor sleep, worry and exhaustion.
You have tried sleep tips, routines or apps, but the problem keeps returning.

If this sounds familiar, CBT-i may help. It is particularly useful when insomnia has become a repeated pattern rather than an occasional bad night.

What CBT-i can help with

Difficulty falling asleep

CBT-i can help when you lie awake for long periods, feel increasingly alert at bedtime, or find that your mind becomes active as soon as you try to sleep. Therapy helps you understand the habits, thoughts and body responses that keep sleeplessness going, and supports practical changes that make sleep more likely to return.

Waking during the night

Some people fall asleep but then wake repeatedly, staying awake for long stretches or becoming anxious about whether they will get back to sleep. CBT-i helps reduce the cycle of night-time worry, clock-checking and frustration, while rebuilding a stronger association between bed and sleep.

Early morning waking

CBT-i can be helpful when you wake too early and cannot return to sleep, particularly if this is linked with stress, low mood, anxiety or a disrupted sleep pattern. Therapy helps you understand what may be maintaining the early waking and supports changes to your sleep schedule, routines and responses during the night.

Sleep anxiety and fear of not coping

Insomnia often becomes more distressing when sleep starts to feel like something you have to control. You may worry about the next day, fear that you will not cope, or feel pressure to “make” sleep happen. CBT-i helps you reduce sleep-related anxiety and respond differently to the thoughts and behaviours that keep the problem active.

Long-term or recurring insomnia

CBT-i is often used when sleep problems have continued for weeks, months or years. It can help whether the difficulty began during a period of stress, illness, life change, shift in routine or emotional strain. Therapy focuses on the maintaining patterns that keep insomnia going now, even if the original trigger has passed.

Related difficulties we often see together.

Insomnia often appears alongside other difficulties. Sleep problems may sit alongside anxiety, stress, burnout, low mood, trauma, chronic pain, health anxiety or major life changes.

Therapy works best when we understand the whole picture while keeping the work focused. We look at how sleep, mood, worry, routines, health, responsibilities and the body’s arousal system interact.

What keeps problems going?

CBT-i looks at the cycle that can develop around sleep. A bad night may lead to worry, frustration, extra time in bed, daytime napping, reduced activity, clock-checking or trying harder to force sleep.

These responses are understandable, but over time they can make sleep feel more pressured and less natural. Bed can become associated with wakefulness, worry and effort rather than rest.

CBT-i helps break this cycle by changing the patterns that keep insomnia going. The aim is not to force sleep, but to create the conditions in which sleep can return more reliably.

How CBT-i therapy helps

At Hampstead Psychology, CBT-i is not delivered as a generic set of sleep tips. We begin by understanding your specific sleep pattern, including when the problem started, what your nights look like now, and what may be maintaining the difficulty.

Therapy then helps you make practical, evidence-based changes. This may include working with sleep routines, time in bed, night-time worry, unhelpful sleep behaviours, anxiety about not sleeping, and the relationship between daytime activity and sleep.

What to expect from sessions

Sessions are structured, practical and collaborative. We usually begin by building a clear picture of your sleep pattern, often using a sleep diary or careful review of your routine, thoughts and behaviours around sleep. The work may involve testing changes between sessions, reviewing what happens, and adjusting the plan carefully. CBT-i can feel active, but it should also be realistic and tailored to your circumstances.

How long does therapy take?

This depends on the nature of the sleep problem, how long it has been present, and whether insomnia is linked with anxiety, low mood, trauma, health difficulties, pain or burnout. Some people benefit from a focused piece of CBT-i. Others may need longer therapy where sleep problems are part of a wider pattern of stress, emotional distress or physical health difficulties. We review progress together so therapy remains purposeful and aligned with your goals.

CBT-i therapy in London and online

We offer CBT-i in person in Hampstead, London, and online across the UK and internationally. Both in-person and online CBT-i can be effective.

Take the next step

If you are struggling with insomnia, sleep anxiety, night waking, early waking or a long-running pattern of poor sleep, CBT-i can offer a practical and evidence-based way forward. Contact Hampstead Psychology to enquire about CBT-i in London or online.

Useful links: Anxiety, Health Anxiety, Stress and Burnout, Chronic Pain, Fees, Meet the Team, Contact.

Urgent Help

If you are worried about immediate risk to your safety, call 999 or go to A&E. If you need urgent support but it isn’t an emergency, contact NHS 111 or your GP. You can also contact Samaritans on 116 123 (24/7).

Meet The Team

At Hampstead Psychology, all of our psychologists have extensive training to doctoral level and decades of experience in their field of expertise. You will be matched with a psychologist that has the knowledge and skill to help you understand and overcome your problem - not just in the short term but for good.