Therapy for sleep problems: What works best?

Reviewed by Brooks Baer, LCPC, CMHP

Written by

therapist.com team

Last updated: 03/17/2026

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Struggling with sleep problems is a very common experience. About 10% of adults deal with insomnia, and another 20% have trouble sleeping at least occasionally.

The good news is that several effective treatments can help you get the rest you need. Here are some of the different interventions you can try and what research tells us about how well they work for restoring sleep.

Cognitive behavioral therapy for insomnia (CBT-I)

Cognitive behavioral therapy for insomnia (CBT-I) is the gold standard treatment for insomnia.¹ This therapy combines several strategies to help you sleep better:²

• Sleep restriction: Limiting time in bed to match your actual sleep time
• Stimulus control: Creating strong connections between your bed and sleep
• Cognitive restructuring: Changing unhelpful thoughts about sleep
• Relaxation training: Learning techniques to calm your mind and body
• Sleep hygiene education: Understanding healthy sleep habits

Research shows that CBT-I works remarkably well. In studies of adolescents with insomnia, CBT-I produced significant improvements in several areas.³ Teens who received CBT-I fell asleep faster, spent less time awake during the night, slept longer overall, and had better sleep efficiency.

But what makes CBT-I so effective? A large study analyzed 241 trials involving over 31,000 adults to find out which parts of cognitive behavioral therapy for sleep problems matter most. The researchers found that four components stood out:⁴

• Cognitive restructuring (challenging negative thoughts about sleep)
• Mindfulness and acceptance techniques
• Sleep restriction
• Stimulus control

The study also found that in-person sessions with a therapist worked better than other delivery methods. These four components working together produced the best results.

Ready to get started with CBT-I? Our directory can help you connect with a qualified professional who specializes in sleep problems. Find a therapist near you to begin your journey toward better sleep.

Digital cognitive behavioral therapy for insomnia (dCBT-I)

Not everyone can access in-person therapy. For some people, digital options may be a helpful and more accessible alternative. Digital CBT-I delivers the same core techniques through apps, websites, or online programs—without requiring face-to-face sessions with a therapist.

The US Food and Drug Administration (FDA) has authorized at least one digital CBT-I program called SleepioRx. In a nationwide study of 336 adults with insomnia, this fully automated program produced impressive results. People using SleepioRx showed meaningful improvements in insomnia severity that lasted at least six months after treatment ended.⁵

This is exciting news because digital programs can reach far more people than traditional therapy, making effective treatment more accessible to those who might not otherwise get help.

Sleep restriction therapy (SRT)

Sleep restriction is a key component of CBT-I, but it can also be effective as a standalone treatment option. Sleep restriction therapy (SRT) focuses on one key principle: less time in bed can lead to better sleep.⁶ This might sound backward, but it often works.

SRT works by limiting your time in bed to match how long you actually sleep. This creates mild sleep deprivation, which strengthens your body’s natural sleep drive and reduces arousal before and during sleep. The result is more consolidated, efficient sleep. Once your sleep improves, you gradually increase time in bed.

SRT has been shown to improve:

• Insomnia severity
• Sleep efficiency (the percentage of time in bed actually spent sleeping)
• How long it takes to fall asleep
• Time spent awake during the night

The effects were especially strong in the short term. However, more research is needed to understand how well these improvements last over time. Additionally, like other self-led lifestyle changes, it can be difficult to sustainably make sleep restriction a part of your routine without structured support.

ACT-based interventions

Acceptance and commitment therapy (ACT) focuses on accepting uncomfortable feelings and thoughts while still taking action toward what matters to you. A form of ACT called acceptance and behavioral changes to treat insomnia (ABC-I) combines ACT principles with behavioral sleep strategies similar to those seen in CBT-I.

In a study of women veterans, researchers compared ABC-I to standard CBT-I. The results showed both treatments worked equally well at improving insomnia.⁷ ABC-I showed some advantages in helping people stick with certain behavioral parts of treatment.

While it’s still being tested and expanded in availability, ABC-I may soon offer a solid alternative for people who don’t respond well to CBT-I or prefer a different approach.

Mindfulness-based therapy for insomnia (MBTI)

Mindfulness-based therapy for insomnia (MBTI) combines mindfulness meditation practices with behavioral sleep strategies. Generally, it teaches you to:

• Pay attention to the present moment
• Accept thoughts and feelings without judgment
• Reduce the mental activity that can interfere with sleep

In one small study, researchers compared MBTI to a program in which participants followed a sleep hygiene and exercise-focused program. Both groups improved their sleep quality significantly, but MBTI showed greater improvements in insomnia severity, and these benefits lasted through six months of follow-up.⁸ The study found that MBTI improved both reported sleep quality and objective measurements from sleep monitors.

For people whose insomnia doesn’t respond to standard treatments, MBTI may offer particular benefits. A study of treatment-resistant patients found that MBTI produced large reductions in insomnia symptoms, depression, and racing thoughts at bedtime.⁹ Nearly 58% of participants no longer had clinical insomnia when measured after treatment. While some effects decreased over six months, improvements in insomnia and nighttime mental activity remained significant.

Alternative therapies for sleep problems

Some people prefer non-psychological approaches or want to combine traditional therapy with other methods. Research-backed alternative therapies include acupuncture and self-administered acupressure.

Acupuncture

Acupuncture is a traditional Chinese medicine practice that involves inserting thin needles at specific points on the body. In a study of 160 cancer survivors with insomnia, both acupuncture and CBT-I produced meaningful improvements. CBT-I reduced insomnia severity more than acupuncture did, but both treatments showed benefits that lasted for months, and both were safe with few side effects.¹⁰

A review of 46 studies involving 3,811 patients found that acupuncture appeared effective for treating insomnia when compared to no treatment or medication.¹¹ However, the researchers noted that many studies had quality issues, so more rigorous research is needed.

Self-administered acupressure

Acupressure is similar in concept to acupuncture but uses pressure on the surface of the body instead of needles. Unlike acupuncture, which involves working with a certified acupuncturist to administer the needles, many people can learn to do acupressure on themselves safely at home.

In a study of 200 people with insomnia, participants learned self-administered acupressure in just two training sessions. Compared to sleep education alone, the acupressure group showed significantly better improvements in insomnia severity at both four and eight weeks.¹² They also reported less anxiety and depression and better overall quality of life.

Finding the right treatment for you

The right treatment depends on your situation, personal preferences, and what’s available to you. CBT-I remains the first-line treatment recommended by experts, with the strongest research support. Digital versions make this evidence-based approach more accessible than ever before.

Take the first step toward better sleep today. Browse our directory of online and in-person therapists who can help you find the right treatment approach for your sleep problems.