Insomnia treatment · CBT-I
Practical treatment for persistent insomnia.
Work on the patterns that may be keeping you awake with Cognitive Behavioural Therapy for Insomnia (CBT-I). Treatment combines clinical assessment, practical changes and regular review.
At a glance
50 minutes · often 6–8 sessions
$150–$225 per session, depending on income
Six sessions · Ask about the current six-session group fee and what it includes.
Secure virtual care across Saskatchewan
When sleep has become something you struggle with
You may be tired but alert as soon as you get into bed, wake during the night and struggle to return to sleep, or begin to dread bedtime. Insomnia can affect concentration, mood and how manageable the next day feels.
CBT-I is a structured, evidence-based psychotherapy for chronic insomnia in adults. It can address behavioural and cognitive patterns while taking relevant health conditions, daily demands and existing care into account.
- Difficulty falling asleep, staying asleep or returning to sleep
- Worry, rumination or pressure to achieve the “right” sleep
- Increasing time in bed to compensate without feeling more rested
- Persistent sleep difficulties alongside stress or anxiety
Why insomnia can keep going
An illustrative maintaining cycle, not an explanation for every sleep difficulty.
01
A difficult night
Sleep feels uncertain.
02
Worry and effort
Monitoring sleep can increase alertness.
03
More time awake in bed
Extending time in bed may add wakefulness.
04
Bed becomes a cue for alertness
Frustration can carry into the next night.
↺ The pattern can repeat. Treatment looks for a useful place to interrupt it.
Understand the pattern, then work on it
Insomnia does not have one universal cause. Sleep timing, time spent awake in bed, arousal, beliefs about sleep and other health factors can interact. Your clinician identifies which methods are appropriate rather than applying every technique in the same way.
Sleep diary and pattern review
Use tracking and discussion to understand what is happening and evaluate changes.
Stimulus control
Work on the association between bed and wakefulness, with practical guidance suited to your circumstances.
Sleep consolidation / restriction
Where appropriate, carefully adjust time in bed to support sleep consolidation, with monitoring and precautions.
Working with nighttime worry and alertness
Explore worries about sleep, the urge to solve problems at night and other experiences that keep you feeling alert.
Sleep hygiene can support treatment, but it is not a sufficient stand-alone treatment for chronic insomnia. The plan also includes strategies for setbacks, travel, stress and illness.
Why more time in bed can backfire
Illustrative comparison — not individualized treatment advice. The bars show the same six hours of sleep within different opportunities; they do not predict a treatment result.
A longer opportunity
10 p.m.–8 a.m. · 10 hours in bed
6 hours asleep / 10 hours in bed = 60% sleep efficiency.
A more consolidated example
Midnight–6:30 a.m. · 6.5 hours in bed
6 hours asleep / 6.5 hours in bed ≈ 92% sleep efficiency.
Solid indigo = estimated sleep. Hatched pale area = wakefulness. Bars show proportions within each opportunity.
The aim is sufficient, more consolidated sleep and better daytime functioning—not a high percentage at the expense of needed sleep. Sleep-window changes need clinical assessment and monitoring, particularly with marked sleepiness, bipolar disorder, seizure disorders or safety-sensitive work.
Two systems shape sleep
Simplified conceptual illustration; not a measurement of your biology.
Sleep pressure
Builds during wakefulness and reduces during sleep.
Wakefulness → sleep →
Circadian timing
Your body clock changes sleep and wake tendencies across roughly 24 hours.
Timing shifts between people and schedules.
Feeling exhausted does not always mean sleep pressure and biological timing are aligned.
Choose the format with your clinician
Individual care
Individual CBT-I
Suitable when you want personalized attention, flexible pacing or support with a complex sleep-anxiety or stress pattern.
- 50-minute individual appointments
- Often 6–8 sessions, weekly or biweekly
- Sleep diary and agreed between-session practice
- Regular review and a plan for times when sleep becomes difficult again
Standard insomnia group
Six-session group CBT-I
Structured weekly skill-building alongside others. Your clinician checks whether a group format fits your clinical needs.
- Six sessions of CBT-I learning and practice
- A time-limited, structured group format
- We’ll check whether the group suits your needs and confirm availability before you enrol
The standard six-session CBT-I group is separate from the eight-week ADHD Sleep Reset Group. They have different formats and program details.
What happens during care
01
Getting to know your sleep
Review your history and relevant health factors. Use appropriate screening and a baseline sleep diary.
02
Build a treatment plan
Agree on priorities and introduce suitable methods. Sleep scheduling and other changes are personalized.
03
Practise and review
Bring your experience and tracking to follow-up appointments. Adjust the plan and prepare for setbacks.
Treatment involves practice between appointments. Your clinician works with you on manageable steps, barriers and pacing. You do not need a perfect diary or a flawless week for the information to be useful.
Some sleep-scheduling methods can initially increase sleepiness. Driving, machinery use and medical or psychiatric considerations are reviewed when planning treatment. Tell your clinician if daytime safety or symptoms change.
What you take into daily life
- A clearer understanding of what may be contributing to your sleep difficulties
- An appropriate sleep schedule, reviewed as treatment progresses
- A practical response to wakefulness in bed
- Strategies for distressing nighttime thoughts and arousal
- Brief agreed practices between appointments
- A plan for maintaining gains and responding to setbacks
Learn more about the evidence: American Academy of Sleep Medicine guideline on behavioural and psychological treatment of chronic insomnia in adults.
Support between appointments
Your clinician may recommend resources through the STG Online Clinic, including the CBT-I course with 32 short lessons and downloadable sleep tools. Resources reinforce the work you do together; they do not replace appointments or medical care.
Your clinician confirms which resources are included with your particular service.
A plan that changes with what you learn
This is a treatment framework, not a fixed number of appointments.
01
Understand
Identify the pattern.
02
Experiment
Try agreed changes.
03
Measure
Notice what happens.
04
Adjust
Refine the plan.
05
Maintain
Prepare for setbacks.
Questions about CBT-I
Will you make me sleep less?
Some CBT-I methods adjust time in bed to support sleep consolidation. They are introduced only when appropriate and are monitored. The goal is improved sleep and functioning, with attention to safety and your health context.
Is CBT-I appropriate for everyone?
Suitability is assessed individually. Medical or psychiatric factors and high-risk driving or machinery work may require precautions, adaptation or another clinical step first.
How long does treatment take?
Individual treatment often involves 6–8 sessions, but the number and spacing depend on assessment, complexity and response. The standard group has six sessions. Your clinician discusses the appropriate format and expected commitment.
What if I take sleep medication?
Discuss medication use during intake. Psychotherapy can work alongside medical care, but medication changes belong with your prescriber. Do not change or stop a prescription on the basis of website information.
Do I need an insomnia diagnosis first?
A formal diagnosis is not required to start intake. Clinical review determines whether CBT-I is appropriate or whether more assessment or medical investigation should come first.
What if I am waiting for a sleep study?
You can ask about intake while waiting. Your clinician considers whether interim support is appropriate and which treatment decisions should wait for medical findings.
Let’s understand what has been making sleep difficult
Tell us what sleep has been like for you. We’ll review your concerns and help you understand which kind of support may be helpful.
Saskatchewan · A specialized service of STG Health Services Inc.