Insomnia treatments — the evidence for CBTi

Sleepstation is an evidence-based and clinically validated sleep improvement programme and a proven solution for people experiencing sleep problems and insomnia symptoms. Delivered entirely online and carefully tailored to each individual, Sleepstation is a fully supported service. Our sleep team guide individuals through a personally tailored and expertly supported programme of Cognitive Behavioural Therapy for insomnia (CBTi). Most people sleep better after three sessions.


The evidence supporting the use of CBTi within Sleepstation

Insomnia is a highly prevalent and costly health problem that often remains untreated despite the availability of effective treatments for insomnia. A specific form of Cognitive Behavioural Therapy (CBT), designed for insomnia (CBTi), is a well validated treatment, with evidence spanning over 30 years. The efficacy of CBTi to improve outcomes in primary and co-morbid insomnia has been repeatedly demonstrated, with improvements in both mental and physical health outcomes. A summary of the key evidence for insomnia treatment, including published evidence for Sleepstation, is outlined below.

There is strong empirical evidence that CBTi is effective and CBTi has been recognised as the first-line treatment for chronic insomnia (National Institutes of Health consensus, British Medical Association). However, the lack of trained therapists and sleep experts prevents widespread availability of this treatment in face-face settings. Sleepstation’s online CBTi programme is an alternative to referring to a sleep clinic for CBTi and/or follow-on prescriptions for sleeping pills and other medications to aid sleep.

Sleepstation can effectively resolve all forms of insomnia. By completing a short questionnaire, those with symptoms of insomnia can find out if Sleepstation could help them overcome their sleep problems for good.

CBTi is effective and long-lasting

There is a large body of evidence, based on over 100 randomised controlled trials (RCTs), for CBTi being an effective and long-lasting treatment for 50%–70% of patients. CBT takes longer than drugs to produce sleep improvements but these improvements are sustained over time. Use of CBTi has been demonstrated to improve most outcomes compared with inactive controls.

The efficacy of Cognitive Behavioural Therapy for insomnia delivered in person has been robustly researched and supported among individuals across all age ranges. CBTi has also been found to be effective for more complex insomnia with comorbid medical and psychiatric conditions.


Jane, 62 from Leeds

Insomnia for more than six years

Amazingly rewarding and very tough. It has changed my life. I now look forward to getting in to bed because I know I will sleep. Having sleep tools has taken away my anxiety. I enjoy living now because the confusing lack-of-sleep fog has been lifted. I laugh more.


Time asleep 4h 01mins

Time in bed 9h 38mins


Time asleep 6h 20mins

Time in bed 6h 56mins

Medications are associated with long-term risks

Pharmacological therapies are widely used in primary care, but there is limited evidence for their benefit in chronic insomnia and increasing evidence that these medications are associated with long-term risks, particularly in an older population.

Antidepressant use for insomnia is widespread, but none is licensed for treatment of insomnia.

A Cochrane review determined that:

The tolerability and safety of antidepressants for insomnia is uncertain due to limited reporting of adverse events. There was no evidence for amitriptyline (despite common use in clinical practice) or for long‐term antidepressant use for insomnia. High‐quality trials of antidepressants for insomnia are needed.

The publications of clinical practice guidelines of multiple international organisations have reached the conclusion that CBTi should be used as the first-line treatment for insomnia. Only when such treatments are not available or not effective should medication be considered for the treatment of persistent insomnia.

No pills

Richard, Manager from Maidstone

Insomnia for more than three years

This course has been fantastic. The results have been life changing. I look forward to going to bed and usually have the confidence to know I will fall asleep within 15 minutes. This course has given me the confidence and tactics to further improve my sleep in the future without sleeping pills! Thank you.

CBTi improves sleep across populations

The efficacy of CBTi to improve outcomes in primary and co-morbid insomnia patients has been repeatedly demonstrated, with improvements in both mental and physical health outcomes.

Comorbidity between chronic insomnia and depression or anxiety is high, and insomnia is a risk factor for both. Chronic insomnia is also highly co-morbid with most major medical conditions. Comorbidity between insomnia and hypertension ranges from 25% to 44%.

CBTi is effective across a variety of populations, including those with medical and psychological comorbidities. Because CBTi does not carry the risks associated with some sleep medications (e.g. dependency, polypharmacy, cognitive and psychomotor impairment), it is an attractive option for patients with other conditions.


Suzanne, 45 from Bolton

Sleep problems for 17 years

I have had a sleeping disorder now for 17 years to which nothing at all worked until I found Sleepstation. I can’t thank you enough as I honestly feel like a different person.

Before therapy – Severe insomnia


After 8 sessions – Normal sleep


Online CBTi is an efficacious treatment

Several small-cohort studies and a number of RCTs have evaluated online CBTi and shown promising results but with varying effect sizes. CBTi tackles factors that maintain insomnia over time, including sleep-related dysfunctional cognitions, behaviours which perpetuate insomnia, and dysregulation of the homeostatic sleep drive.

A systematic review found that internet-delivered CBTi appears efficacious and can be considered a viable option in the treatment of insomnia.


Sandra, Cafe owner from Leeds

Insomnia for fourteen months

Since finishing Sleepstation my head’s back in the game! I feel normal again and I’ve got a dog. I’d always wanted a dog but until now I’d never had the motivation and energy to get one.

Sleepstation is highly effective

From the evidence outlined above, it is clear that CBTi is an effective intervention, applicable to online delivery. In 2014 we published a review of the effectiveness of Sleepstation compared to other online CBTi programmes.

The study found that Sleepstation produced large improvements in our primary endpoint of sleep efficiency. There were also clear improvements in sleep latency, with modest improvements in total sleep time. The majority of participants reported improved sleep quality after completing the Sleepstation programme. Participant feedback was overwhelmingly positive.

Once participants fulfilled criteria for insomnia and had commenced therapy, the attrition rate was low, and compliance with sleep diaries and therapy recommendations was high.

In the years since this study, we have continued to adapt and evolve the Sleepstation programme and, in our most recent study, Sleepstation was found to be three times more engaging than other online CBTi programmes. It is thought that our impressive engagement rates are due to the supported nature of the Sleepstation programme. Sleepstation remains the only online CBTi programme to be fully supported by a team of sleep experts, therapists and coaches.


Sarah, Probation Officer from Ilford

Symptoms of severe depression and insomnia

Having the sleep coaches’ support and encouragement for different techniques to apply really helped. The support has been great and my sleep has improved greatly.


CBTi can improve mental health

Several RCTs and studies show that understanding and treating disrupted sleep through CBTi could provide a key route to improving mental health. In the largest ever RCT of a psychological treatment for mental health, individuals who received online CBTi showed reduction in insomnia as well as improvements in depression, anxiety, and psychological wellbeing.

Depression increases during menopause, and subclinical depressive symptoms increase risk for major depression. Insomnia is common among postmenopausal women and increases depression-risk in this already-vulnerable population. CBTi and sleep restriction therapy were found to reduce depressive symptoms and dysfunctional beliefs about sleep in postmenopausal women, with CBTi producing superior results.

  • Anxiety around sleep
  • Moderate general anxiety
  • Moderate-severe depression
  • No anxiety around sleep
  • No general anxiety
  • No longer depressed

Jackie, Dinner lady from Leicester

Insomnia for six months

Being accepted onto the Sleepstation programme has completely turned my life around. Before the course I was paralysed by anxiety, had been signed off work and dreaded going to bed due to the sleep problems I had been experiencing for months. Within a few weeks of being on the course, the quality of my sleep had improved and the anxiety levels started dropping. I feel so lucky to have found the course as it has given me my life back.

Let’s start fixing your sleep problem today

If you feel that you should be sleeping better, we can help. Answer a few short questions to find the best solution for your sleep problem.