Frequently Asked Questions

Sleep hygiene (e.g. limiting caffeine etc) can be useful, but it does not address the underlying mechanisms that maintain chronic insomnia. Research consistently shows it is insufficient as a standalone treatment. Similarly, apps and digital platforms can offer helpful information, but they cannot assess your individual clinical picture, adapt in real time, or provide the quality of human support that specialist-led treatment offers. Many clients come to The Sleep Sphere having already tried both.
CBT-I is recommended by the NHS and NICE as the first-line treatment for chronic insomnia - ahead of medication. However, access through NHS services is limited. There are fewer than ten dedicated specialist insomnia services in the UK, and waiting times can be very long. Many people are offered medication as a default simply because specialist CBT-I is not readily available in their area. Private specialist treatment at The Sleep Sphere offers prompt access to a comprehensive clinical assessment and a structured, one-to-one programme - led by an NHS-trained specialist - without the wait.
Many clients come to The Sleep Sphere while taking sleep medication - whether prescribed sleeping tablets, over-the-counter remedies, or supplements. CBT-I can be delivered effectively alongside medication and there is no requirement to stop before starting the programme. For many people, building the skills and confidence that CBT-I provides creates a natural foundation from which to reduce reliance on medication over time, should they wish to. This is something that can be discussed as part of the assessment.
CBT-I is available in different formats, including NHS services and digital programmes, and these can be a helpful starting point for some people.
Private CBT-I offers a more personalised, human, and in-depth approach. We work together one-to-one to understand your specific sleep pattern, the factors maintaining it, and how best to address these. The process is tailored throughout, rather than following a rigid, fixed programme.
It also allows for continuity, flexibility, empathetic support, and the opportunity to adjust the approach in real time as your sleep evolves.
Many people choose this route after trying other options and finding they need a more individualised, specialist approach.
Sleep restriction is probably the most googled - and most widely misunderstood - aspect of CBT-I. What people tend to find online often sounds very alarming: drastically cutting time in bed, extreme bedtimes. It is completely understandable that this puts people off, or that they arrive at the assessment with real apprehension about it.
However, the reality is different and much more nuanced -and importantly, not all practitioners approach this in the same way.
CBT-I is a rich, multi-component programme that draws on a range of different techniques - cognitive, behavioural, and educational. Sleep scheduling is only one element within that broader framework, not the sum of it.
Working with the relationship between time spent in bed and time actually asleep is one part of the programme - because spending long hours in bed while sleeping poorly is one of the key ways insomnia sustains itself over time. But how that is done matters enormously.
At The Sleep Sphere, this is approached as sleep compression (rather than ‘sleep restriction’) - a gradual, carefully guided process rather than an extreme one. The approach is tailored to your individual picture, explained clearly at every stage, and paced in a way that is manageable. You will be supported with compassionate, practical strategies for moments that feel harder.
You will always understand the rationale behind what is being asked of you, not just the instruction itself.
Most clients find that when the process is properly understood and supported throughout, it is far more workable than they feared. And the results - more consolidated, more reliable sleep - are well worth the initial effort.

CBT-I works best for people who have been experiencing persistent sleep difficulties - typically for three months or longer - and who are ready to engage actively with a structured programme. Our clients tend to be thoughtful, motivated individuals who want to understand what is maintaining their insomnia and are committed to making meaningful change. If you are curious about the science behind your sleep and willing to approach the process with patience and openness, you are likely a good fit.
Not at all. In fact, many of our most successful clients have been struggling for years - sometimes decades and decades - before seeking specialist help. The duration of insomnia does not determine how well you will respond to CBT-I. What matters more is your willingness to engage with the process
Chronic insomnia is often highly resistant to general approaches precisely because those approaches don't address the underlying mechanisms that maintain it. CBT-I works differently - it targets the specific thought patterns, behaviours and physiological responses that keep insomnia going, regardless of how long you have been struggling or what you have tried before. Many clients come to The Sleep Sphere having already tried apps, programmes, medication, sleep hygiene and other interventions. This is not a barrier - in fact, understanding what hasn't worked and why is often a useful part of the clinical picture.
CBT-I is highly effective for the majority of people with chronic insomnia, but it is not the right fit for everyone - and we think it is important to be honest about that.
This approach tends to be less well-suited to those who are currently experiencing acute mental health crisis, significant trauma, or severe anxiety as a primary concern - in these cases, addressing those needs first is usually the more appropriate path.
If you are currently in an acute crisis or looking for day-to-day reassurance or support, a different form of support may be more appropriate for you.
Similarly, those looking for a quick fix or passive solution may find the active, structured nature of CBT-I challenging.
CBT-I also works best when approached with openness and a willingness to trust the process, even when progress feels gradual.
Those who find it difficult to tolerate uncertainty may find this approach less well suited to their needs.
The assessment is specifically designed to ensure that this is the right approach for you at this time, and if it is not, Dr Michelle will discuss this openly and help signpost the most appropriate next steps.
The programme typically consists of six sessions, following an initial assessment.
It is a structured, step-by-step process where we work together to:
- establish a stable and consistent sleep pattern
- strengthen sleep drive and support your natural biological rhythm
- address night-time wakefulness and a racing mind
- reduce sleep-related anxiety
- build long-term confidence in your sleep
Each stage is introduced gradually and tailored to your individual sleep pattern, so the approach is personalised throughout.

No, you can contact The Sleep Sphere directly. A referral is not required.
Treatment is delivered as a structured six-session programme, typically once a week with each session lasting approximately one hour. This is the clinically recommended number of sessions to help ensure lasting long-term change in your sleep.
The early phase of the programme - typically the first two to three weeks - can feel harder before it feels better. Some of the techniques involve changes that initially increase tiredness before sleep consolidates and improves. This is not a sign that something is wrong; it is an expected clinically positive sign and is how the treatment works.
Most clients begin to notice meaningful changes from around weeks three to five, and by the end of the six sessions, the majority of those who engage fully will have experienced - not perfect sleep every single night - but significant, lasting improvements in their sleep.
CBT-I is not a quick fix, but it is a lasting one, and that is precisely its strength.
Yes and this is an important part of how CBT-I works. Clients are asked to keep a daily sleep diary and to engage with the techniques discussed between sessions. The work that happens between appointments is as important as the sessions themselves. Those who engage most fully tend to achieve the most lasting results.
Setbacks and difficult nights are a normal and expected part of the process - they do not mean the treatment isn't working.
Insomnia rarely improves in a straight line, and learning to respond differently to a difficult night is itself an important part of the programme.
Dr Michelle will equip you with specific strategies for navigating these moments - including what to do on a difficult night, how to think about a run of poorer sleep, and how to stay the course when progress feels uneven.
This is an active part of the clinical work, not an afterthought. Between scheduled sessions, clients are asked to continue with their sleep diary and the techniques discussed.
The goal of the programme is your independence, rather than ongoing reliance on sessions. Relapse prevention is a formal part of the CBT-I protocol and is addressed directly in the final session.
You will leave with a thorough understanding of what was maintaining your insomnia, a personalised set of tools, and a clear self-management plan for handling any future difficulties into the future.
Research shows that for most people, sleep continues to improve after the programme ends - the skills learned keep working.
Occasional difficult nights and blips here and there are a normal part of life and they do not indicate that treatment has failed; knowing how to respond to them without falling back into the cycle of effort and worry is itself one of the key outcomes of the programme.
A follow-up session one month following the end of the programme can often be useful. Furthermore, beyond the programme, you’ll be very welcome to contact me any time if you have any questions or if you’d like an occasional ‘refresher’ session in the future.

You’re very welcome to email with brief practical questions between sessions.
However, the work is designed to unfold within the sessions themselves. Keeping some space between sessions is often an important part of building confidence and helping reduce over-monitoring of sleep.
I aim to respond as soon as reasonably possible - though I’m not always able to reply immediately due to clinic demands.
This service is not designed for urgent or crisis support.
If you are experiencing significant distress or need immediate help, please contact your GP or appropriate support services.

A final word

Chronic insomnia is one of the most treatable conditions there is - and for the vast majority of people who engage fully with the process, the programme works. Not partially, not temporarily, but genuinely and lastingly. Clients who have struggled for years, who have tried many things, who have almost given up on the idea of sleeping well again - many of them find that their sleep improves in ways they did not think were possible.

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