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Cognitive Behavioral Therapy for Insomnia (CBT-I) is proven to be the most effective first-line treatment for adults with chronic insomnia.


  • CBT-I has an 80% effectiveness rate with lasting results.   

  • Studies show that when compared to sleeping medication, CBT-I was more effective and had better lasting results.

  • The American College of Physicians recommends CBT-I as first tier Initial Treatment for adults with chronic insomnia. 

  • Improvement is typically rapid; people often show substantial recovery in 3 - 5 sessions.


CBT-I fixes sleep problems using a series of changes in sleep-related behaviors. CBT-I identifies and eliminates sleep blocking habits that were learned over time or that may have been started with the intention to fix sleep problems.

Dr. Hoekstra will work with you to identify the important targets for behavior change so you can focus on making changes that will produce improvements in your sleep. Most people respond to CBT-I treatment quickly. Some experience significant improvement in their sleeping problems after as little as 2 sessions. Most improve after 3 to 5 sessions.  Some may need more. Research demonstrates that treatment is equally effective when sessions are in person or virtual via telephone and/or video conference. 

CBT-I focuses on addressing 4 main factors that contribute to the stubbornness of insomnia:


A terrible name for a very helpful tool! This step is designed to eliminate middle night awakenings and to decrease time spent waiting for sleep onset. Gradually, successful sleep time is increased until sleep deficit effects are gone. Usually, people experience marked improvement in the quality of sleep after this step occurs.


This set of instructions addresses conditioned (learned) arousal. It is designed to strengthen the bed as a cue for sleep and weaken it as a cue for wakefulness. It addresses sleep and wake time and how to effectively transform the sleep space into a powerful trigger for sleep.


This includes a variety of relaxation techniques, stress management skills, and reducing sleep-related worries. Use of cognitive therapy to reduce arousal by helping patients shift from "trying hard to sleep" to "allowing sleep to happen."


Bed time and rise time should fit with your circadian clock, the biological process that naturally and automatically helps keep us asleep during the night. When the desired bedtime and wake times are not synced with your circadian clock, interventions can help shift the circadian clock to be more helpful to you. Therapeutic bright light is one such tool.

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