What is cognitive behavioural therapy for insomnia (CBT-i)?

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Insomnia can be caused by various factors, such as changes in hormones, but it's one's reaction to not getting sleep that may habituate insomnia and make it worse.

Cognitive Behavioural Therapy for Insomnia (CBT-i) works by managing those reactions, and creating healthier thoughts, feelings, and behaviours that bring on sleep naturally.

CBT-i can be a useful treatment for insomnia and its benefits can last for a long time even after treatment has ended.1 It is recommended as a first-line treatment for insomnia before medication,2 and can be effective even for hormonal-driven insomnia like during menopause.3

How does CBT-i work?

CBT-i therapy involves meeting a sleep psychologist for several sessions over multiple weeks. The CBT-i program is structured based on 6 key components – sleep diary, hygiene, control, sleep drive, relax, and thoughts. These components are selected and personalised to the individual, and aimed at modifying behaviours and thoughts to promote better sleep.


Learn more about these components and see an example of a CBT-i program schedule here.

How long does CBT-i take to work?

Improvements in sleep quality and duration may be seen within 2 to 3 weeks of starting CBT-i, and sleep keeps improving as you continue with the program.4

The great news is that sleep often keeps getting better even after you finish the program. The more effort you put into practicing the CBT-i techniques learned, the more your sleep will benefit in the long run.

Who is CBT-i for?

CBT-i is suitable for most people with long periods of insomnia. It is effective for people of all ages including those with co-existing conditions and medications such as:

  • Sleeping pills: Taking or not taking5
  • Women’s health: Pregnancy,6 menopause3
  • Sleep health: Sleep apnea7
  • Mental health: Anxiety,8 depression9

Why haven’t I heard of CBT-i before?

CBT-i is recommended as the first-line therapy for insomnia, but finding a qualified CBT-i therapist can be hard. Even if you do, there may be a long waiting list, and attending in-person sessions can be a hassle.

How is CBT-i different at Rivi™?

At Rivi, we understand that women’s sleep challenges are complex and nuanced, requiring a deeply personalised approach. Factors that affect women’s sleep may include hormonal fluctuations (e.g. menstrual cycle, pregnancy, post-partum, and menopause), medical issues (e.g. depression, anxiety, headaches, breast cancer, and etc.), and unique family dynamics (e.g. breastfeeding, co-sleeping, care giving responsibilities).

Our CBT-i approach is holistic — we look at the whole woman, the whole story, the full picture, and deliver a personalised therapy experience that starts with the causes and considers your individual context, contributory circumstances, and co-existing conditions. Ultimately working with you towards, and through to, your desired outcomes.

We also understand that you may be time-poor and already exhausted from the adverse effects from prolonged poor sleep.

That’s why we’ve made CBT-i available online for your convenience, so you can have access to the therapy from wherever you are in Australia.

We’re here to guide and support you every step of the way towards better sleep.

We’ve got you, and you’ve got this.

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Rivi by ResMed

Rivi by ResMed is your personalised sleep health pathway. Designed holistically for women, delivered wherever you’re at.

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Source: Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, Cunnington D. Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis. Ann Intern Med. 2015 Aug 4;163(3):191-204. doi: 10.7326/M14-2841. PMID: 26054060.


Source: Ree M, Junge M, Cunnington D. Australasian Sleep Association position statement regarding the use of psychological/behavioral treatments in the management of insomnia in adults. Sleep Med. 2017 Aug;36 Suppl 1:S43-S47. doi: 10.1016/j.sleep.2017.03.017. PMID: 28648226.


Source: Drake CL, Kalmbach DA, Arnedt JT, Cheng P, Tonnu CV, Cuamatzi-Castelan A, Fellman-Couture C. Treating chronic insomnia in postmenopausal women: a randomized clinical trial comparing cognitive-behavioral therapy for insomnia, sleep restrictiohn therapy, and sleep hygiene education. Sleep. 2019 Feb 1;42(2):zsy217.


Source: Morin CM, Beaulieu-Bonneau S, Ivers H, Vallières A, Guay B, Savard J, Mérette C. Speed and trajectory of changes of insomnia symptoms during acute treatment with cognitive-behavioral therapy, singly and combined with medication. Sleep Med. 2014 Jun;15(6):701-7.


Source: van Straten A, van der Zweerde T, Kleiboer A, Cuijpers P, Morin CM, Lancee J. Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis. Sleep Med Rev. 2018 Apr;38:3-16.


Source: vZheng X, Zhu Z, Chen J, He J, Zhu Y, Zhang L, Qu F. Efficacy of cognitive behavioural therapy for insomnia or sleep disturbance in pregnant women: A systematic review ad meta-analysis. J Sleep Res. 2022 Dec 18:e13808.


Source: Sweetman A, Lack L, Lambert S, Gradisar M, Harris J. Does comorbid obstructive sleep apnea impair the effectiveness of cognitive and behavioral therapy for insomnia? Sleep Med. 2017 Nov;39:38-46.


Source: Jansson-Fröjmark M, Jacobson K. Cognitive behavioural therapy for insomnia for patients with co-morbid generalized anxiety disorder: an open trial on clinical outcomes and putative mechanisms. Behav Cogn Psychother. 2021 Sep;49(5):540-555.


Source: Manber R, Buysse DJ, Edinger J, Krystal A, Luther JF, Wisniewski SR, Trockel M, Kraemer HC, Thase ME. Efficacy of Cognitive-Behavioral Therapy for Insomnia Combined With Antidepressant Pharmacotherapy in Patients With Comorbid Depression and Insomnia: A Randomized Controlled Trial. J Clin Psychiatry. 2016 Oct;77(10):e1316-e1323.