Clinically reviewed by the Massachusetts Sleep Center clinical team · September 2026
Cognitive Behavioral Therapy for Insomnia (CBT-I) uses your sleep history and a daily sleep diary to build a treatment plan. A licensed clinician helps you adjust sleep habits and manage thoughts that keep you awake.
Each morning you write down when you got into bed, roughly when you fell asleep, how often you woke and for how long, when you woke for good, and when you got up.
Brief estimates are enough. You do not need to watch the clock or record every minute precisely.
| Your morning entry | What it tells your clinician |
|---|---|
| When you turned the light out, and when you think you fell asleep | How long it takes you to fall asleep |
| How often you woke in the night, and for how long | How often your sleep is interrupted and how long you remain awake |
| When you woke for good, and when you got up | How much time you spend awake in bed after your final awakening |
| Every one of these, across fourteen nights | Your sleep efficiency: the share of your time in bed that is spent asleep |
Sleep efficiency is the percentage of time in bed spent asleep. Your clinician considers this alongside total sleep, daytime symptoms and your health when planning treatment.
Two behavioral components of CBT-I are a personalized sleep window and stimulus control. Your clinician explains how to use them safely and adjusts them to your needs.
Your clinician may initially reduce time in bed to bring it closer to the amount you are sleeping. The schedule is based on your diary, health and daily responsibilities.
As sleep becomes more consistent, your clinician gradually increases time in bed. You review progress together rather than setting a restrictive schedule on your own.
Stimulus control helps reduce the association between bed and wakefulness. Your clinician guides you in keeping a consistent wake time and responding to periods when you cannot sleep.
Calculating how few hours remain before your alarm can make it harder to relax. Worry about the next day may keep you alert even when you feel exhausted.
The cognitive part of CBT-I helps you examine these thoughts and develop more helpful responses. You work with your clinician on expectations about sleep, bedtime anxiety and fear of another difficult night.
Insomnia may start during stress, illness or a change in routine. It is considered chronic when difficulty sleeping occurs at least three nights a week for three months or more, despite enough opportunity to sleep, and affects you during the day.
Some ways of coping, such as spending extra time in bed or taking long naps, can unintentionally maintain insomnia. Worry about sleep can also contribute. CBT-I addresses these patterns while taking other health concerns into account.
The American College of Physicians recommends CBT-I as the initial treatment for chronic insomnia. The American Academy of Sleep Medicine also strongly recommends it. Treatment teaches skills that patients can continue using after sessions finish.
Many people who complete CBT-I no longer meet the criteria for insomnia, and follow-up studies show lasting improvement. Results vary, and occasional bad nights may still happen. Treatment includes a plan for responding when sleep problems return.
You can start CBT-I while taking sleep medication. Tell your clinician what you take and whether reducing it is a goal. We do not prescribe; any medication changes are coordinated with your prescriber. Do not stop or adjust a prescription on your own.
Insomnia and sleep apnea often occur together. We treat insomnia and coordinate referrals to partners who treat apnea. If you snore loudly or someone has noticed pauses in your breathing, our sleep study guide explains when testing may help.
You work with a Massachusetts-licensed clinician trained in CBT-I. They review your diary, discuss progress and adjust the plan with you. Read the profiles below to learn about their experience and choose a clinician.
Insomnia specialist
Specialities: Insomnia, Anxiety, Substance abuse
Approaches: Cognitive Behavioral Therapy, Mindfulness, Motivational interviewing
Eneida Qirko is a licensed mental health counselor with over 15 years of experience working with children, teens, and adults who are navigating a wide range of mental health concerns, including anxiety, depression, PTSD, relationship stress, life transitions, body image concerns, ADHD, ASD, and mood and personality disorders. She uses evidence-based approaches such as CBT, DBT, ACT, mindfulness, EMDR, and trauma-focused therapies, tailoring treatment to each client’s unique needs. Eneida brings a broad clinical perspective informed by her work in outpatient mental health clinics, emergency departments, private practice, court systems, schools supporting students with ASD, and substance use treatment settings. She has also completed specialized training in Cognitive Behavioral Therapy for Insomnia (CBT-I), allowing her to support clients with evidence-based strategies to improve sleep alongside their mental health goals.
Book with Eneida
Insomnia specialist
Specialities: Insomnia, Anxiety, Self Esteem, Depression
Approaches: Cognitive Behavioral Therapy, Motivational interviewing
Maureen Gebhardt is a Licensed Independent Clinical Social Worker who works with young adults and individuals across the lifespan on a range of issues, including addiction, depression, anxiety, relationship challenges, and work stress. She uses evidence-based techniques and a holistic, integrated mental and physical health approach to help clients manage and improve their wellbeing. Maureen has completed specialized training in Cognitive Behavioral Therapy for Insomnia (CBT-I), equipping her to help clients struggling with sleep difficulties. She is committed to creating a safe, supportive, and nonjudgmental space where clients can build on their strengths, develop practical tools for resilience, and take meaningful steps toward the life they want.
Book with MaureenMassachusetts Sleep Center is in network with Aetna, Blue Cross Blue Shield, Cigna / Evernorth, Harvard Pilgrim, Medicare, Tufts Health Plan, UnitedHealthcare / Optum and Veterans Affairs Community Care Network. CBT-I sessions are billed as behavioral health visits. Ask us to check your plan's coverage and expected costs before the first appointment.
We accept Aetna, Blue Cross Blue Shield, Cigna / Evernorth, Harvard Pilgrim, Medicare, Tufts Health Plan, UnitedHealthcare / Optum and Veterans Affairs Community Care Network and bill CBT-I as outpatient behavioral health care. Coverage, copays and deductibles depend on your specific plan. Share your insurance details when booking so we can check your benefits before the first visit.
Yes. Our clinicians are licensed to treat patients across Massachusetts. Most visits are by video. Limited in-person appointments are available; confirm availability when you book.
Sleep hygiene covers general habits, such as caffeine use and bedroom conditions. CBT-I goes further by addressing sleep schedules, time awake in bed and worry about sleep. It can help when general advice has not been enough.
You are welcome to bring it. Wearable devices estimate sleep and may mistake quiet wakefulness for sleep. Your clinician will also ask you to keep a sleep diary, which records your experience and helps guide treatment.
You leave with a plan for managing future sleep difficulties. Studies show that CBT-I benefits can continue after treatment ends. The skills you learn can help you respond to setbacks and decide when to seek further support.
Meet with a Massachusetts clinician to discuss your sleep and next steps. Read about anxiety therapy if worry also affects you, or explore our treatment approach for more detail.
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