Insomnia programme

Also called: CBT-I, cognitive behavioural therapy for insomnia.

Last reviewed 2026-09-16. How this works.

Persistent insomnia Grade A

Randomised human evidence of benefit.

A short course of talking therapy for sleep works well, and it works better than sleep advice alone.

Nineteen randomised trials, 1,803 cancer survivors, against real control conditions.

The claim

The claim is that persistent sleeplessness after cancer treatment can be treated with a structured talking therapy rather than with medication or with advice about bedtime routines.

What it does

The programme works on the thoughts and habits that keep insomnia going once whatever started it has passed. That distinction is why it outperforms sleep hygiene advice, which addresses only the habits.

The evidence

Nineteen randomised controlled trials covering 1,803 cancer survivors with clinically significant insomnia compared this therapy against usual care, wait list, attention control, or sleep hygiene education alone.1

That list of comparators is what makes this an A rather than a B. Being tested against attention control and against sleep hygiene education, rather than only against nothing, means the benefit is not simply the effect of receiving attention.1

An earlier pooling of eight trials across 752 cancer survivors found sleep efficiency improved by 15.5 percent against 6.1 percent in control conditions, a medium effect.2

The studies this rests on

  • Pooled randomised trials of cognitive behavioural therapy for insomnia in cancer survivors1

    A meta-analysis, summarising randomised trials, measured what patients reported, 1803 participants.

    improvement in insomnia severity against usual care, wait list, attention control and sleep hygiene education.

What to ask

Could I be referred for a sleep programme rather than given something to help me sleep?

The dish-to-person gap

A sleep programme is not a compound that reaches a concentration in the blood, so the dish-to-person comparison does not apply.

When to call your team — no warning signs are recorded

If you have started something new, or are thinking about it, the people treating you can only weigh it if they know about it. That is true when nothing has been written down here, and it is most true then.

The register records no warning signs for this entry.

Interactions

A talking or behavioural treatment is not checked against treatment classes in this register.

The whole interaction list, and how to turn it into a pharmacy review request.

Find a trial instead

This is also available outside trials, and asking for a referral is usually the faster route.

Search ClinicalTrials.gov for recruiting studies of cognitive behavioral therapy for insomnia OR CBT-I

A trial is the same decision with monitoring, a known preparation and a doctor who knows what else you are taking.

References

  1. Effects of cognitive-behavioral therapy for insomnia compared with controls among cancer survivors: a systematic review and meta-analysis of randomized trials. BMC Cancer 2025. PROSPERO CRD42022332584.

    doi:10.1186/s12885-025-14192-y · PubMed 40369457

    How this was reached: transcribed from chapter note, via docs/CHAPTER-NOTES.json, chapter 22 note 12.

  2. A systematic review and meta-analysis of randomized controlled trials of cognitive behavior therapy for insomnia in cancer survivors. Sleep Medicine Reviews, 2015.

    No persistent identifier recorded.

    How this was reached: transcribed from chapter note, via docs/CHAPTER-NOTES.json, chapter 22 note 13.