CBT-I stands for cognitive behavioral therapy for insomnia. The name is unhelpfully broad, and it gets used loosely enough that a lot of people arrive here having read about it three times without ever being told what it is.
It is a defined set of techniques, not general advice about sleep. The core of it is sleep restriction — compressing time in bed to match the sleep actually happening — together with stimulus control, which rebuilds the association between the bed and sleeping. Around those sit cognitive work on the thoughts that keep someone awake, and a sleep diary that supplies the numbers everything else is calculated from. Sleep hygiene, the list about caffeine and screens and a dark bedroom, is the part most people have already tried. It is included in most programs and it is the weakest component of them.
The distinction matters because of where CBT-I sits in clinical guidance. The American College of Physicians' 2016 guideline recommends it as the first-line approach for chronic insomnia in adults, ahead of medication. The American Academy of Sleep Medicine's 2021 behavioral guideline reaches the same position on the multicomponent version. That is unusual for a behavioral approach, and it is the reason a six-week program of homework competes at all with a prescription.
What follows are the questions people actually ask before starting: what it costs, whether an app can do the job a therapist does, what six weeks of it involves week by week, and whether melatonin is a reasonable substitute. Where the honest answer is unflattering — and on the melatonin question and the first two weeks of sleep restriction it is — the articles say so.
