Insomnia Treatment
CBT-I is recommended internationally as the gold-standard treatment for insomnia by the NHS, the British Medical Association and the National Institute of Health (NIH) in the United States - backed by over 200 randomised controlled trials.
What is CBT-I?
Cognitive Behavioural Therapy for Insomnia (CBT-I) is a structured, evidence-based programme that addresses the underlying mechanisms that cause and maintain insomnia - not just the symptoms. It is not a form of general counselling, and it is not the same as sleep hygiene advice.
CBT-I has two core components. The behavioural element works to retrain the brain's association between bed and sleep, and to gradually strengthen your natural sleep drive. The cognitive element addresses the worry, mental hyperarousal, and unhelpful thought patterns that typically develop when sleep becomes a persistent struggle - including the exhausting cycle of trying harder to sleep, monitoring, and watching the clock.
Paradoxically, the effort to sleep - and the vigilance that develops around it - is itself one of the key things that keeps insomnia going. Learning to reduce that effort, and to rebuild a more natural, effortless relationship with sleep, is central to what CBT-I achieves.
One of the most common misconceptions about CBT-I is that it is simply sleep restriction or that it involves being told to get out of bed in the middle of the night regardless of how you feel. This is not accurate, and understandably puts many people off seeking help.
CBT-I is a multi-component programme. Sleep compression (reducing time spent awake) is one tool among several — always applied carefully, gradually, and adapted to your individual circumstances, health, and lifestyle. If you have come across CBT-I before and felt it wasn't for you based on what you'd read about sleep restriction, it is worth having a conversation before ruling it out.
What CBT-I includes
A personalised CBT-I programme at The Sleep Sphere typically includes:
Tailored sleep education - understanding how sleep works and what is maintaining your insomnia
Retraining your brain to associate bed reliably with sleep
Sleep drive optimisation - working with your body's natural sleep mechanisms
Reducing sleep effort and sleep vigilance - addressing the counterproductive cycle of trying harder to sleep and monitoring every sensation, both of which sustain insomnia rather than resolve it
Cognitive techniques - managing the racing thoughts, worry, and mental hyperarousal that keep you awake
Individually tailored adjustments to sleep timing, where appropriate
A personalised long-term plan for maintaining your progress independently
CBT-I tackles insomnia by addressing its root causes rather than masking its symptoms. Its benefits are sustained long-term - well beyond the end of the programme - and it has been shown to be effective even in those who have experienced poor sleep for decades.
It is effective across all ages and has been used successfully alongside physical and mental health conditions including depression, anxiety, cancer, chronic pain, and heart disease.
Most clients begin to notice meaningful improvements within around four weeks of starting. Some experience change sooner; others take more time. The pace is guided carefully throughout.
CBT-I at The Sleep Sphere is specialist-led, but the outcomes depend on what happens between sessions as much as within them. Clients are asked to keep a daily sleep diary, engage with the techniques discussed, and approach the process with patience over several weeks. Those who commit to this tend to achieve the most lasting results.
Many clients come to The Sleep Sphere having already tried apps, digital programmes, or AI-based tools for their sleep. These can be a useful starting point - but persistent or complex insomnia, particularly where sleep effort and vigilance have become deeply ingrained, often requires the kind of nuanced, personalised clinical guidance that only a specialist can provide.
Teenage (Age 16+) Insomnia Treatment
Teenagers face a distinctive set of sleep challenges - shifting body clocks, academic and social pressures, and the pull of screens and devices. When these combine with persistent insomnia, the impact on mood, performance, and wellbeing can be significant.
Dr Michelle works with older teenagers aged 16 and above who are experiencing insomnia - difficulty falling asleep, staying asleep, or waking too early. The approach is carefully adapted to suit the individual young person, drawing on CBT-I techniques within a structure that feels engaging and age-appropriate rather than clinical.
Please note that some teenage sleep difficulties — such as delayed sleep phase disorder — may be better suited to a different specialist service. If you are unsure whether this is the right fit, get in touch and we will help you find the most appropriate support.
What does the programme involve?
Dr Michelle works with clients online worldwide via structured video sessions, and in person at a dedicated clinic space in central Cambridge. Sessions are typically weekly, each lasting approximately one hour, across a programme of six sessions.
Addressing insomnia is not an overnight process, particularly where difficulties have been longstanding. We are committed to providing expert guidance so that you feel supported, stay on track, and finish the programme equipped to manage your sleep independently, long after the sessions end.
Who do we help?
This approach is suited to individuals experiencing persistent insomnia, whether that presents as difficulty falling asleep, staying asleep, or waking earlier than intended.
For many people, sleep gradually becomes less predictable following periods of stress, disruption, or change - and over time, the efforts to fix it can themselves become part of what keeps it going.
Clients come from varied stages of life. What tends to unite those who do best is a willingness to engage with a structured process over several weeks, an openness to doing things differently and a degree of trust in the process, even when progress feels gradual or the approach feels counterintuitive at first.
CBT-I works well alongside mild to moderate anxiety, low mood, and stress - these are common features of chronic insomnia and are addressed within the programme.
However, this approach is less suited to those who are currently in acute mental health crisis, or where significant trauma or severe anxiety is the primary clinical concern. In those cases, a different or additional form of support is likely to be more appropriate as a first step - and we are happy to help point you in the right direction.