How to Find CBT-I Treatment

As mentioned above, a gap exists at the center of insomnia care. The first recommended treatment by the American Academy of Sleep Medicine (AASM) and the American College of Physicians (ACP) is one most people have never been offered or heard of: cognitive behavioral therapy for insomnia (CBT-I).45

Who actually provides CBT-I

From a medical perspective, CBT-I falls under the category of behavioral sleep medicine. It is most often practiced by psychologists with specific sleep training, which is formally recognized through certification in behavioral sleep medicine by the American Board of Sleep Medicine (ABSM).1

The two directories worth knowing

For CBT-I providers: the Society of Behavioral Sleep Medicine maintains a directory of members offering clinical services, including CBT-I, and flags those with ABSM certification in behavioral sleep medicine. The AASM directs patients to this directory.1

For sleep centers: the AASM's Sleep Education sleep center directory lists accredited facilities and can be searched by distance and by state.2

You can use the AASM's Sleep Education sleep center directory if you think you might be experiencing something other than insomnia. Specifically, if you wake unrefreshed despite sleeping for what feels like sufficient time, if anyone has mentioned your breathing at night, or if you have morning headaches. Those are among the characteristic symptoms of obstructive sleep apnea. For diagnosis of obstructive sleep apnea, in-laboratory polysomnography is the gold standard; however, it must come from a sleep center rather than from a behavioral specialist.7

What to expect from a CBT-I course

Historically, CBT-I has been provided in-person, weekly, for four to eight sessions.4 You will be asked to keep a sleep diary from the outset since the treatment is calculated from your own data rather than delivered as a fixed curriculum. Given the issues of access and cost, there are now CBT-I formats available through digital delivery (e.g., an app) or through telehealth.

Regardless of the format, the important work happens between sessions. The sessions set the schedule, review what occurred, and adjust your plan accordingly.

If there is no qualified provider near you

Unfortunately, not having one nearby is common, and not just your imagination or bad luck. There are far fewer trained providers than are needed to cover all people with chronic insomnia.6 This is precisely why the AASM suggests digital CBT-I "when CBT-I access at sleep centers is limited."3

Asking your doctor

Asking your primary care provider is a good first step, mainly because they can evaluate the symptoms and make referrals for treatment. However, be prepared for CBT-I not to be the first suggestion or even a suggestion at all. While CBT-I is an established treatment protocol, many primary care providers may not be familiar with that treatment as an option for chronic insomnia.

A useful way to ask: "I think I have chronic insomnia. The guidelines recommend CBT-I first — is that available to me through a referral?" That phrasing accomplishes two things at the same time. It signals that you know what you are asking for, and it opens the CBT-I referral conversation.

A note on "sleep coaches"

The title is unprotected. Anyone may use the term, and it carries no defined training, certification, or professional qualifications.

Some coaches are genuinely trained and useful. Others are selling sleep-hygiene advice, which the AASM's 2021 guideline specifically says should not be used as a single-component treatment for chronic insomnia.4 The title alone will not tell you what you are dealing with, so you should ask: what training do you have, and do you deliver the full CBT-I protocol, including sleep restriction and stimulus control?