Veronica Smith couldn’t sleep. As a freshman in college, she found herself tossing and turning all night, every night. “I would feel just drained, low energy, hard time concentrating,” she tells SELF. “I felt like I could sleep for days if I had the chance.”
Over the next few years, she completed her undergraduate degree, headed to grad school, and started her career. Throughout it all, the insomnia continued. She tried everything to fix it: sleeping pills, acupuncture, meditation, cutting out caffeine, speaking with various sleep specialists, and even getting a stellate ganglion block, an injection recommended for veterans who have insomnia and PTSD. Nothing worked as a long-term solution. But in June 2025, her therapist asked her if she had tried cognitive behavior therapy for insomnia, commonly referred to as CBT-I. Smith hadn’t.
While she was initially skeptical of the treatment—an evidence-based psychotherapy approach widely considered to be the gold standard for treating insomnia, involving a six-to-eight week program of regular therapy, daily exercises, and routine shifts—she ultimately decided to try it, pairing it with eye movement desensitization and reprocessing (EMDR) therapy at the suggestion of her therapist. It worked.
“It was a miracle,” she says. “I’m a disciplined person. I’m a type-A person. I do routines and all of the things. But this really helped.”
For many of us, the concept of sleep training conjures images of parents attempting to teach their infants to self-soothe: Ferber, “fading,” the “chair method” are just a few that terms might ring a bell. But those aren’t the only ways to teach someone better sleep. Adults—like Smith—are increasingly turning to CBT-I, where instead of focusing on just one aspect of someone’s sleeping issues, such as anxiety around getting shut-eye or lack of a quality bedtime routine, they take a more holistic approach.
What does adult sleep training entail?
On social media, sleep-obsessed influencers will suggest a litany of hacks to try for better shut-eye. But when it comes to CBT-I, the protocol is straightforward.
The five components of CBT-I (sleep hygiene, relaxation or stress reduction, stimulus control therapy, sleep restriction, and cognitive therapy) address unproductive behaviors that people learn over time to cope with their insomnia, says Meredith Broderick, MD, a neurologist and board-certified sleep and behavioral sleep medicine specialist. These behaviors, or adaptations, may include spending a lot of time in bed, not scheduling certain activities due to a fear of not sleeping, or resting a lot during the day, Dr. Broderick says. (However, note that none of these behaviors actually fix insomnia.)
The most well-known aspect of CBT-I is its sleep restriction requirement, which aims to match your sleep ability (the amount of time you actually sleep for) with your sleep opportunity (the amount of time you spend trying to sleep). Depending on your personal habits, a therapist, doctor, or clinician trained in CBT-I will determine a set window for your sleep. Over the course of the treatment period, you cannot go to bed before that predetermined, agreed-upon time—no matter how challenging it may seem. This shift is typically paired with a number of other changes, including weekly meetings with a CBT-I therapist and an agreement to only use your bed for sleeping and sex (in order to have it be associated with quality shut-eye). During your virtual or in-person sessions with your CBT-I specialist, you’ll dig into your thoughts about sleep, evaluate your individual sleep data, and discuss what healthy sleep looks like.
Even for seasoned insomniacs, these changes can feel drastic. Throughout her adult life, Alex Kelly struggled with her sleep. After she left her corporate job, her habits worsened. She found herself lying awake for hours, constantly ruminating as her husband snoozed soundly beside her. She ultimately decided to try CBT-I at the urging of her sleep doctor. Her window was from midnight to 7 a.m.—with some stipulations. “If you’re not tired at midnight, you cannot go to sleep,” she tells me. “You have to wait until you’re actually tired.” While the first few days were extremely difficult, she soon started to notice a change. “In just seven days, I was already feeling very tired when I would go to bed, and most of the time when I was in bed, I was actually sleeping,” she says. “I couldn’t believe it.”
The length of CBT-I treatment varies from person to person. However, on average, people tend to meet their goals for improving their sleep after about six sessions, says Amoha Bajaj, PhD, a clinical and health psychologist. After trying a variety of methods for years—or even decades—many are often surprised to discover just how effective CBT-I can be at combating insomnia. To experts who have studied the treatment for years, the reason why is clear: “It’s so successful because it’s considered to be a behavioral intervention,” Dr. Bajaj says. Rather than simply adding another element to your shut-eye routine, CBT-I seeks to rewire your approach to sleep in general, targeting your feelings and thoughts around the practice.
The rise in popularity of CBT-I, or adult sleep training
Formally developed at the end of the 20th century, over time, CBT-I has steadily risen in popularity. In 2016, the American College of Physicians recommended that adult patients receive CBT-I as the initial treatment for chronic insomnia. More recently, Dr. Broderick has seen an uptick in younger populations seeking out the treatment. She attributes the boom to a number of factors, including the publication of Matt Walker’s Why We Sleep, the health-conscious nature of millennials and Gen Z, and the widespread use of sleep trackers. However, she often finds that interested parties don’t always meet the definition of someone who has chronic insomnia—difficulty falling or staying asleep for at least three days a week for more than three months—or aren’t willing to commit to the rules of the protocol.
Dr. Broderick emphasizes that enduring just a few sleepless nights doesn’t mean you have chronic insomnia. Instead, this condition is best defined by one of its key features, conditioned arousal, a subconscious association of the bed with wakefulness. As a result, getting a diagnosis from a qualified provider before embarking on CBT-I is key. “CBT-I works,” she adds. “It’s one of the most studied, one of the most effective treatments in all of medicine, but I can’t do it for you. You have to do it.”
Like many of the people seeking out CBT-I today, Katharine Keton first learned about the treatment from a podcast. After digging into it more, she decided to give it a try. Around the second week, she started to notice key changes: Her sensitivity to light and sound decreased, and she started sleeping through the night without waking up. Keton ultimately wasn’t able to finish the protocol due to travel obligations. (She says she completed about 30 to 40 days of the treatment.) Even so, in the time since, her sleep hasn’t regressed. (Yes, much like for babies, sleep regressions are a widely discussed subject in the adult sleep training world too.) “I’m still sleeping through the night, totally and completely,” she says. And while she eventually hopes to clock an eight-hour night, she says she’s satisfied with her current routine. “I haven’t gotten to a 10 p.m. bedtime, but that sounds super dreamy,” she says. “I have done seven hours and 45 minutes. That’s the longest I’ve gone.”