Protocol · Sleep and recovery
CBT-I (cognitive behavioral therapy for insomnia)
Insomnia remission and better sleep continuity
Evidence type: Randomized trials
The graded dose: 4 to 8 sessions combining stimulus control, sleep restriction (a prescribed sleep window), cognitive therapy, and sleep hygiene; therapist-delivered, group, or validated digital program. Frequency in the evidence: 1 session per week. Program length in the evidence: 6 to 8 weeks. The grade attaches to this dose; below it, the grade does not apply.
The caveat: No separate popular claim: the marketed claim and the evidence claim are the same, which is unique in this library so far.
Time cost
45 minutes / week
Program-phase cost (sessions plus diary time) for 6 to 8 weeks, then near zero. Recorded as a program cost, not a perpetual weekly cost.
Dollar cost
About $25 / month
One-time program fee, not a subscription: validated digital programs about $100 to $300 total; therapist-delivered about $400 to $1,200 total; books and free programs exist. Midpoint shown amortized over 12 months. (basis: program-fee)
Every claim, graded
Each outcome this protocol is claimed to deliver carries its own grade and its own kind of evidence. A strong secondary outcome never launders a weak popular claim: the popular claim prints at its own grade, next to the headline.
| Claim | Grade | Evidence | What the data show |
|---|---|---|---|
| Insomnia remission and better sleep continuity | A | rctRandomized trials | Trauer 2015 (Annals of Internal Medicine): 20 RCTs, n=1,162 with chronic insomnia; sleep onset latency fell 19.03 min, wake after sleep onset fell 26.00 min, sleep efficiency rose 9.91%, effects sustained at follow-up. Wu 2015 (JAMA Internal Medicine, comorbid insomnia): remission 36.0% vs 16.9% (OR 3.28), sleep efficiency Hedges g 0.91. First-line treatment for chronic insomnia in the American College of Physicians guideline (Qaseem 2016), ahead of medication.Trauer JM et al., Annals of Internal Medicine, 2015; Wu JQ et al., JAMA Internal Medicine, 2015; Qaseem A et al. (ACP guideline), Annals of Internal Medicine, 2016 |
Dose and response
The dose is the program: stimulus control plus a prescribed sleep window (sleep restriction), cognitive therapy, and sleep hygiene, adjusted weekly. Partial completion delivers partial effect; the diary data are part of the treatment, not paperwork.
Equipment that can deliver this dose: None required, Clinical setting.
Harms and cautions
Harms live in this ledger, not inside the grade: the grade is evidence for the claimed outcomes in the studied population.
Medication interactions
No medication classes are flagged in this graded record.
Goal conflicts and timing
No goal conflicts in this record.
Pattern rules are intrinsic to the therapy and sourced to it: a fixed wake time every day, and a prescribed sleep window adjusted weekly by the program.
Population exclusions and other cautions
Sleep restriction lowers seizure threshold and can precipitate mania: seizure history and bipolar disorderserious
Exclusions from self-guided restriction; clinician involvement required
Source: Longevity Lab Report evidence review, 2026-10-18
Transiently increased daytime sleepiness during the first 1 to 2 weeks of sleep restrictioncaution
Warning for driving and safety-sensitive work in weeks 1 to 2
Source: Longevity Lab Report evidence review, 2026-10-18
Pregnancy during sleep restrictioncaution
Clinician involvement required
Source: Longevity Lab Report evidence review, 2026-10-18
Can you measure it yourself?
Insomnia remission and better sleep continuity
- Metric
- Insomnia Severity Index (ISI) and diary sleep efficiency
- Method
- Sleep diary plus ISI questionnaire at completion and 3 months
- Baseline
- 2 weeks of sleep diary before starting
- Minimum run
- 6 weeks; retest: ISI at completion and at 3 months
Noise note: An ISI change of about 6 points is the established minimum clinically important difference; diary efficiency varies night to night by 10% or more, so judge weekly averages and act on a sustained 5-point gain.
Outcomes without a measurement block carry none because no effect is established for them: a self-experiment cannot test a claim the evidence has not made.
Goals served
Sleep
Derived from outcomes grading B- or better, never hand-assigned.
Experience gate
intermediate and up (gated for supervision)
The gate applies to the full program including sleep restriction. Self-guided digital CBT-I without the sensitive-population flags is the beginner-accessible form; the record grades the full program.
Applicability
targeted
Applies to a specific goal or population, not broadly.
Grades are research summaries, not medical advice. Decisions about your own stack belong with your clinician.
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Frequently asked questions
What grade does CBT-I (cognitive behavioral therapy for insomnia) get?
At the studied dose (a 4 to 8 session program over 6 to 8 weeks), CBT-I (cognitive behavioral therapy for insomnia) grades A for insomnia remission and better sleep continuity, on randomized trials. The grade attaches to that dose; below it, the grade does not apply.
How much time does CBT-I (cognitive behavioral therapy for insomnia) take each week?
At the graded dose, 45 minutes per week, counted as session time plus standard overhead, travel excluded. Dollar cost: One-time program fee, not a subscription: validated digital programs about $100 to $300 total; therapist-delivered about $400 to $1,200 total; books and free programs exist. Midpoint shown amortized over 12 months..
Who should not use CBT-I (cognitive behavioral therapy for insomnia)?
Sleep restriction lowers seizure threshold and can precipitate mania: seizure history and bipolar disorder. Exclusions from self-guided restriction; clinician involvement required. The full harm ledger is on this page, and the medical line applies: decisions about your own stack belong with your clinician.
Sources
- Trauer JM et al. Cognitive behavioral therapy for chronic insomnia: systematic review and meta-analysis. Annals of Internal Medicine, 2015. (2015)
- Qaseem A et al. Management of chronic insomnia disorder in adults (ACP guideline). Annals of Internal Medicine, 2016. (2016)
Last reviewed October 18, 2026
- 2026-10-18|Initial grading from the 2026-10-18 protocol inventory evidence review.
- 2026-10-18|Update: goal assignments are now recorded for each outcome individually, not only for the record as a whole. No grades, doses, or claims changed.