CBT-I vs. Sleep Hygiene

Sleep hygiene is a set of general recommendations. CBT-I is a treatment. As a standalone intervention for chronic insomnia, sleep hygiene has consistently underperformed; clinical guidelines specifically recommend against using it alone.

What sleep hygiene covers

Caffeine and alcohol timing, a cool dark room, limiting screens, regular exercise. These are reasonable conditions for sleep, and they help some people at the margins. They do not address the mechanisms that maintain chronic insomnia.

What CBT-I adds

• Sleep restriction or compression — matching time in bed to actual sleep ability to rebuild sleep pressure and consolidate sleep.
• Stimulus control — re-establishing bed as a cue for sleep rather than for wakefulness and effort.
• Cognitive therapy — targeting catastrophic beliefs about sleep loss and the effortful "trying to sleep" that raises arousal.
• Arousal down-regulation — practiced methods for reducing physiological and cognitive activation.
• Circadian alignment — placing the sleep window where the clock can support it.

The practical implication

If someone has followed good sleep hygiene for months and still cannot sleep, that is not a failure of effort. It usually means the maintaining mechanisms have never been treated. See the full CBT-I guide.