Sleeping pills manage a symptom. Cognitive behavioral therapy for insomnia retrains the system that produces sleep, and the benefit holds after treatment ends. SOMOS delivers it as a structured, clinician-guided program built around your data, not a generic app course.
A short clinical intake maps your sleep pattern, daytime function, and risk factors, and screens for an airway problem hiding behind the insomnia. Behavioral therapy cannot fix a breathing problem, so we rule it in or out before you start.
Sleep restriction, stimulus control, cognitive restructuring, and relaxation training, sequenced week by week. Your provider sets the prescribed sleep window from your own diary data and moves it as your sleep efficiency improves.
Your clinician reviews your data between sessions and adjusts the plan, so progress doesn't stall between appointments. When you're consolidated, you leave with a relapse plan rather than an open-ended dependency.
Hypnotics work quickly, and for short-term, situational insomnia they have a place. The problem is what happens next. Sedatives produce sleep that is chemically induced rather than physiologically restored, tolerance often builds, and when the medication stops the insomnia frequently returns, sometimes worse than before. CBT-I performs comparably to medication in the short term and outperforms it at follow-up, because it changes the conditions that keep insomnia running rather than overriding them each night. [1, 2]
Chronic insomnia is maintained by a learned loop: time in bed expands to chase sleep, the bed becomes associated with being awake and anxious, and effort to sleep becomes the thing preventing it. Every component of CBT-I targets a specific link in that loop.
Sleep restriction compresses your time in bed to match the sleep you're actually getting, which rebuilds sleep pressure and consolidates fragmented nights. It is the most effective component and the one people most often get wrong on their own. Stimulus control re-establishes the bed as a cue for sleep instead of a cue for frustration. Cognitive restructuring addresses the catastrophic arithmetic that runs at 3am about tomorrow. Relaxation and wind-down work lowers pre-sleep arousal so the physiology can follow. [1]
This is not sleep hygiene. Sleep hygiene advice, on its own, is not recommended as a standalone treatment for chronic insomnia in current guidelines. It's the floor, not the treatment. [1, 3]
CBT-I is the right first move if you have trouble falling asleep or staying asleep at least three nights a week, it has been going on for three months or longer, and it is affecting how you function during the day. It's also the right move if you are on a sleep medication and want a route off it, though any taper should be planned with your prescriber rather than attempted abruptly.
It is not the whole answer if untreated sleep apnea, an unmanaged mood disorder, a circadian rhythm disorder, or restless legs is driving the awakenings. Insomnia and sleep apnea co-occur often enough to have their own name, COMISA, and the pair does best when both are treated. That's precisely why we assess before we treat. [4]
Most structured CBT-I programs run four to eight sessions over several weeks. Many people notice meaningful change within the first two to three weeks of consistent practice, though sleep restriction often makes the first week feel harder before it improves.
Clinical guidelines recommend CBT-I as first-line treatment for chronic insomnia. It performs comparably to hypnotics in the short term and its benefits are more durable after treatment ends, without medication side effects, tolerance, or rebound insomnia on discontinuation.
That combination is common and has a name: COMISA, comorbid insomnia and sleep apnea. CBT-I still helps, but it works best alongside treatment for the breathing problem. SOMOS screens for sleep apnea before starting CBT-I so you aren't treating only half the problem.
Yes. Many people begin CBT-I while still on a hypnotic and taper later, once their sleep has consolidated. Never stop a sleep medication abruptly on your own, particularly benzodiazepines or z-drugs. Your provider will coordinate the taper with whoever prescribes it.
No. Sleep hygiene alone has not been shown to resolve chronic insomnia. CBT-I is a structured behavioral protocol with defined components, sleep restriction and stimulus control chief among them, delivered and titrated by a clinician using your own sleep diary data.
No. The program is delivered remotely by board-certified providers, and if we need objective sleep data we can arrange testing you complete at home rather than in a lab.
Start with the SOMOS baseline assessment. It takes a few minutes, a board-certified provider reviews your results, and we tell you honestly whether CBT-I is the right path for you.