CBT for Insomnia (CBT-I) Course: How-To Module

What the module teaches

Module 9 of the PsychoPharmRef therapy course is a practical guide to CBT for insomnia, which the module presents as the recommended first-line treatment for chronic insomnia disorder, ahead of hypnotic medication, per the American College of Physicians and the American Academy of Sleep Medicine. The Learn tab covers the 3-P (Spielman) model, assessment and the sleep diary, the components of CBT-I, sleep restriction therapy, stimulus control, cognitive therapy, relaxation, sleep hygiene as an adjunct only, a typical 4-8 session course, adaptations and hypnotic tapering, and outcome measures led by the Insomnia Severity Index.

Interactive worksheets

• Sleep Diary. A prospective morning diary. From clock times and minutes it calculates total sleep time, time in bed and sleep efficiency (SE = total sleep time / time in bed), with means across all entries.
• Sleep Prescription. Sets the initial time in bed from mean total sleep time, rounded to 5 minutes and never below a 5-hour floor, and gives the matching bedtime for a fixed rise time. A weekly titration tool then adjusts time in bed by mean sleep efficiency.
• Stimulus Control. Bootzin's instructions as a personal adherence checklist, with space for the individual plan and obstacles.
• Cognitive Restructuring. For each unhelpful belief about sleep, rate how strongly it is held, weigh the evidence, build a balanced alternative, and re-rate.

Weekly mean SE	Time-in-bed change
≥90%	Increase by 15 minutes
85-89%	Hold
<85%	Decrease by 15 minutes, never below 5 hours

The tool notes that these thresholds vary between protocols. It keeps the rise time fixed and applies changes to bedtime. Each worksheet copies to dated plain text, and a blank, fill-by-hand PDF can be downloaded from the module header.

Who it is for and cautions

The module is written for clinicians, trainees and advanced students. The worksheets are practice aids, not validated instruments, and do not replace clinical judgment or supervision. Screen for and address other sleep disorders, such as obstructive sleep apnea, before starting sleep restriction. Warn patients that daytime sleepiness rises in the first 1-2 weeks, and address driving and work safety.