Sleep medication can help in the short term, but CBT-I is the treatment sleep doctors reach for first. Here's why.
Cognitive Behavioral Therapy for Insomnia (CBT-I) is recommended by the American Academy of Sleep Medicine as the first-line treatment for chronic insomnia, ahead of medication.
Unlike sleeping pills, which manage symptoms while you're taking them, CBT-I targets the behaviors and thought patterns that perpetuate poor sleep — which is why its benefits tend to last well after the program ends.
This doesn't mean medication has no role. For some people, short-term use alongside CBT-I can help break an acute crisis. But as a long-term strategy, the evidence consistently favors behavioral treatment.
Clinical trials comparing the two consistently find CBT-I at least as effective as medication for chronic insomnia, with the added advantage that its benefits tend to persist after treatment ends, which medication's effects generally do not.
No. CBT-I can be used alongside medication. Any changes to a prescription should be made with the prescribing physician, not based on starting a behavioral program alone.
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