Cited by 391Sleep and related disordersHealth Policy Implementation ScienceObstructive Sleep Apnea Research

The DOI matches its Crossref record; 82 of the 82 references it cites were found in a registry or an index.

Increasing access to and utilization of cognitive behavioral therapy for insomnia (CBT-I): a narrative review

Open access

Koffel, Erin, Bramoweth, Adam D., Ulmer, Christi S.·2018·Journal of General Internal Medicine

DOI 10.1007/s11606-018-4390-1PMC PMC5975165

Open this paper in CoChat — free account Open PDF

Abstract

The American College of Physicians (ACP) recently identified cognitive behavioral therapy for insomnia (CBT-I) as the first-line treatment for insomnia. Although CBT-I improves sleep outcomes and reduces the risks associated with reliance on hypnotics, patients are rarely referred to this treatment, especially in primary care where most insomnia treatment is provided. We reviewed the evidence about barriers to CBT-I referrals and efforts to increase the use of CBT-I services. PubMed, PsycINFO, and Embase were searched on January 11, 2018; additional titles were added based on a review of bibliographies and expert opinion and 51 articles were included in the results of this narrative review. Implementation research testing specific interventions to increase routine and sustained use of CBT-I was lacking. Most research focused on pre-implementation work that revealed the complexity of delivering CBT-I in routine healthcare settings due to three distinct categories of barriers. First, system barriers result in limited access to CBT-I and behavioral sleep medicine (BSM) providers. Second, primary care providers are not adequately screening for sleep issues and referring appropriately due to a lack of knowledge, treatment beliefs, and a lack of motivation to assess and treat insomnia. Finally, patient barriers, including a lack of knowledge, treatment beliefs, and limited access, prevent patients from engaging in CBT-I. These findings are organized using a conceptual model to represent the many challenges inherent in providing guideline-concordant insomnia care. We conclude with an agenda for future implementation research to systematically address these challenges.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1007/s11606-018-4390-1

Cites

82 of 82 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
Why Don't Physicians Follow Clinical Practice Guidelines?: A Framework for Improvement
Cabana, M. D., Rand, C. S., Powe, N. R., Wu, A. W., Wilson, M. H., Abboud, P.-A. C., & Rubin, H. R. (1999) · JAMA · doi:10.1001/jama.282.15.1458 · Cited by 6,677
The Insomnia Severity Index: Psychometric Indicators to Detect Insomnia Cases and Evaluate Treatment Response
Morin, C. M., Belleville, G., Bélanger, L., & Ivers, H. (2011) · Sleep · doi:10.1093/sleep/34.5.601 · Cited by 4,620
Effectiveness-implementation Hybrid Designs: Combining Elements of Clinical Effectiveness and Implementation Research to Enhance Public Health Impact
Curran, G. M., Bauer, M., Mittman, B., Pyne, J. M., & Stetler, C. (2012) · Medical Care · doi:10.1097/mlr.0b013e3182408812 · Cited by 4,058
International Classification of Sleep Disorders
Thorpy, M. (2017) · Sleep Disorders Medicine · doi:10.1007/978-1-4939-6578-6_27 · Cited by 2,505
Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians
Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., Denberg, T. D., & for the Clinical Guidelines Committee of the American College of Physicians* (2016) · Annals of Internal Medicine · doi:10.7326/m15-2175 · Cited by 1,965
Clinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults
Schutte-Rodin, S., Broch, L., Buysse, D., Dorsey, C., & Sateia, M. (2008) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.27286 · Cited by 1,943
Nonpharmacologic Treatment of Chronic Insomnia
Morin, C. M., Hauri, P. J., Espie, C. A., Spielman, A. J., Buysse, D. J., & Bootzin, R. R. (1999) · Sleep · doi:10.1093/sleep/22.8.1134 · Cited by 888
Efficacy of Brief Behavioral Treatment for Chronic Insomnia in Older Adults
Buysse, D. J., Germain, A., Moul, D. E., Franzen, P. L., Brar, L. K., Fletcher, M. E., Begley, A. E., Houck, P. R., Mazumdar, S., Reynolds, C. F., et al. (2011) · Archives of Internal Medicine · doi:10.1001/archinternmed.2010.535 · Cited by 562

Show all 82 references

Research works printed but not linked: 1

Moss TG, Lachowski AM, Carney CE. What all treatment providers should know about sleep hygiene recommendations. The Behavior Therapist. 2013;36(4):76–83.

Sorted by citations

Items 101–200 of 391

Who to Refer to a Behavioral Insomnia Clinic? — Recommendations Based on Treatment Rationale and Response Prediction
Cho, H. J., Kremer, S., & Young, J. (2021) · Current Sleep Medicine Reports · doi:10.1007/s40675-021-00220-3 · Cited by 15
Implementation and Effectiveness of Cognitive Behavioral Therapy for Insomnia in Geriatric Primary Care
Hinrichsen, G. A., & Leipzig, R. M. (2022) · Clinical Gerontologist · doi:10.1080/07317115.2022.2104675 · Cited by 13
“Patient barriers include unwillingness to engage in CBT-I because of effort required to engage in it (vs apparent relative ease of taking a sleep medication; Koffel et al., 2018).”
Background
Effects of digital sleep interventions on sleep and psychological health during the COVID-19 pandemic: A systematic review and meta-analysis
Zhang, H., Yang, Y., Hao, X., Qin, Y., & Li, K. (2023) · Sleep Medicine · doi:10.1016/j.sleep.2023.07.036 · Cited by 15
Co-prescribing of Opioids with Benzodiazepines and Other Hypnotics for Chronic Pain and Insomnia: Trends and Health Outcomes
Koffel, E., DeRonne, B., & Hawkins, E. J. (2020) · Pain Medicine · doi:10.1093/pm/pnaa054 · Cited by 15
Self-citation
Treating insomnia in Swiss primary care practices: A survey study based on case vignettes
Linder, S., Duss, S. B., Dvořák, C., Merlo, C., Essig, S., Tal, K., Giovane, C. D., Syrogiannouli, L., Heinzer, R. C., Nissen, C., et al. (2020) · Journal of Sleep Research · doi:10.1111/jsr.13169 · Cited by 13
“…support this, as half of the PCPs in our present study felt pressure to prescribe hypnotics − Nonetheless, non-pharmacological treatment was prescribed more often than pharmacological treatment; (d) clinicians may lack of motivation, time and resources to manage insomnia (Koffel et al., 2018).”
Background
A qualitative examination of the usability of a digital cognitive behavioral therapy for insomnia program after stroke
Smejka, T., Henry, A., Wheatley, C., Espie, C., Johansen-Berg, H., & Fleming, M. (2022) · Brain Injury · doi:10.1080/02699052.2022.2034182 · Cited by 10
“Widespread access to inperson CBT-I is typically limited due to a lack of trained professionals and geographical distance (13).”
Background
A Pilot Study Testing the Efficacy of dCBT in Patients With Cancer Experiencing Sleep Problems
Chung, K., Suh, Y. J., Chin, S., Seo, D., Yu, E., Lee, H. J., Kim, J., Kim, S. W., & Koh, S. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.699168 · Cited by 13
“Conversely, growing evidence of efficacy has been accumulated in CBT-I for adults with primary insomnia (Koffel et al., 2018; van Straten et al., 2018; Boness et al., 2020), as well as diverse medical and psychiatric conditions (van Straten et al., 2018).”
Background
Online prenatal trial in mindfulness sleep management (OPTIMISM): Protocol for a pilot randomized controlled trial
Kantrowitz-Gordon, I., McCurry, S. M., Landis, C. A., Lee, R., & Wi, D. (2020) · Pilot and Feasibility Studies · doi:10.1186/s40814-020-00675-1 · Cited by 11
“Despite the high prevalence of sleep disturbance during pregnancy, effective behavioral treatments are largely inaccessible because of time, cost, and insufficient numbers of trained therapists [46].”
Background
Digital Therapeutics for Insomnia: Assessing the Effectiveness of a Computerized Home-Based Cognitive Stimulation Program
Tapia, J. L., Puertas, F. J., & Duñabeitia, J. A. (2023) · Journal of Integrative Neuroscience · doi:10.31083/j.jin2202034 · Cited by 12
“Furthermore, some of the CBT-I components present certain contraindications.”
BackgroundInfluential
Barriers in Access to and Delivery of Behavioral Sleep Treatments
Roberts, S., & Ulmer, C. S. (2023) · Current Sleep Medicine Reports · doi:10.1007/s40675-023-00270-9 · Cited by 15
“Moreover, taking time out of their schedules, coordinating childcare, and traveling to see a sleep provider to participate in 4–8 weeks of hour-long sessions (such as is standard in CBTi) may not be feasible for many patients [52].”
InfluentialSelf-citation
Efficacy of eHealth Versus In-Person Cognitive Behavioral Therapy for Insomnia: Systematic Review and Meta-Analysis of Equivalence
Knutzen, S. M., Christensen, D. S., Cairns, P., Damholdt, M. F., Amidi, A., & Zachariae, R. H. (2024) · JMIR Mental Health · doi:10.2196/58217 · Cited by 14
“These include insufficient numbers of trained CBTI providers, low rates of referral by primary care physicians, and geographical and physical barriers that deter patients from receiving help [32-34].”
Background
Real-World Evaluation of Clinical Response and Long-Term Healthcare Resource Utilization Patterns Following Treatment with a Digital Therapeutic for Chronic Insomnia
Forma, F. M., Knight, T., Thorndike, F. P., Xiong, X. R., Baik, R., Velez, F. F., Maricich, Y. A., & Malone, D. C. (2022) · ClinicoEconomics and Outcomes Research · doi:10.2147/ceor.s368780 · Cited by 12
“With the significant shortage in licensed clinicians who can deliver CBT-I, delayed access to evidence-based treatment may increase morbidity as patients wait to receive needed care.(27) During these waiting periods, which Table 1 Patient Characteristics and Demographics”
Background
Sleep Discrepancy in a Randomized Controlled Trial of Brief Behavioral Therapy for Chronic Insomnia in Older Adults
Chan, W. S., Dautovich, N. D., McNamara, J. P. H., Stripling, A. M., Dzierzewski, J. M., McCoy, K. J. M., & McCrae, C. S. (2020) · Behavioral Sleep Medicine · doi:10.1080/15402002.2020.1726750 · Cited by 14
Declining trend in use of medications for sleep disturbance in the United States from 2013 to 2018
Kaufmann, C. N., Spira, A. P., Wickwire, E. M., Mojtabai, R., Ancoli‐Israel, S., Fung, C. H., & Malhotra, A. (2022) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.10132 · Cited by 11
A randomized trial to evaluate the effects of a supervised exercise program on insomnia in patients with non-metastatic breast cancer undergoing chemotherapy: design of the FATSOMCAN study
Drozd, C., Curtit, E., Jacquinot, Q., Marquine, C., Mansi, L., Chaigneau, L., Dobi, E., Viot, J., Meynard, G., Paillard, M., et al. (2023) · BMC Cancer · doi:10.1186/s12885-023-10902-6 · Cited by 12
“Nevertheless, further treatment options for insomnia are necessary, since CBT-I is often unavailable for patients, and may be complex to implement in clinical routine, while poor adherence can decrease its effectiveness [11].”
Background
A comprehensive insight on cognitive behavioral therapy for insomnia in pregnant women: A systematic review and meta-analysis
Shang, X., Ye, L., Wang, M. P., Lam, T. H., & Lai, A. Y. K. (2023) · Sleep Medicine · doi:10.1016/j.sleep.2023.11.002 · Cited by 12
Representation of race and ethnicity among cancer survivors in trials of cognitive behavioral therapy for insomnia (CBT-I): A systematic review
Li, R., Ma, Y., Hall, K. A. A., Johnson, C., Philpotts, L. L., Perez, G. K., Park, E. R., & Hall, D. L. (2023) · Supportive Care in Cancer · doi:10.1007/s00520-023-08207-2 · Cited by 12
“The most utilized therapies for insomnia are hypnotics and sleep hygiene [4, 6].”
Expanding Access to CBT-I for Older Adults: Review and Expansion of Recent Recommendations
Hughes, J. M. (2023) · Current Sleep Medicine Reports · doi:10.1007/s40675-023-00271-8 · Cited by 11
“The efficacy and safety of CBT-I for older adults is well established [16, 17 • , 18 • ]; yet, access remains limited [19, 20].”
Treatment of chronic insomnia in adults
Clarke, K., Orlov, N. M., & Soong, C. (2024) · Canadian Family Physician · doi:10.46747/cfp.7003176 · Cited by 12
A Comprehensive Review of Lemborexant to Treat Insomnia
Fuller, M. C., Carlson, S. F., Grant, C., Berry, V., Ivancich, M. S., Cornett, E. M., Kaye, A. M., Viswanath, O., Urits, I., Shekoohi, S., et al. (2025) · Psychopharmacology Bulletin · doi:10.64719/pb.4483 · Cited by 11
Effectiveness of Information and Communication Technology–Based Cognitive Behavioral Therapy Using the Smart Sleep App on Insomnia in Older Adults: Randomized Controlled Trial
Kim, C. H., Lee, Y.-J., Kang, S., & Lee, S. H. (2025) · Journal of Medical Internet Research · doi:10.2196/67751 · Cited by 13
The relationship between military occupation and diagnosed insomnia following combat deployment
MacGregor, A. J., Markwald, R. R., Dougherty, A. L., & Seda, G. (2020) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.8444 · Cited by 12
“36 Many primary care providers are not adequately screening for insomnia or making referrals for cognitive-behavioral therapy for insomnia because of a lack of knowledge and treatment beliefs.”
Scaling up sleep education and cognitive behavioral therapy for insomnia training across multiple health disciplines
Vargas, I. (2023) · SLEEP · doi:10.1093/sleep/zsad204 · Cited by 10
Positive psychological traits predict future sleep quality and quantity: exploring emotion regulation as a common mediator
Tout, A. F., Jessop, D. C., & Miles, E. (2024) · Psychology and Health · doi:10.1080/08870446.2024.2314722 · Cited by 10
“…could provide individuals with an easy, inexpensive and self-administrable solution to sleep problems in day-to-day life, while avoiding the negative side-effects of sedative medications (Schroeck et al., 2016) and the demands of cognitive behavioural therapy for insomnia (Koffel et al., 2018).”
The Latest Advances in Non-Invasive Neurostimulation for Insomnia: A Review
Liu, W., & Li, G. (2025) · Nature and Science of Sleep · doi:10.2147/nss.s501619 · Cited by 10
Sleep to Reduce Incident Depression Effectively (STRIDE): study protocol for a randomized controlled trial comparing stepped-care cognitive-behavioral therapy for insomnia versus sleep education control to prevent major depression
Drake, C. L., Kalmbach, D. A., Cheng, P., Ahmedani, B. K., Peterson, E. L., Joseph, C. L. M., Roth, T. G., Kidwell, K., & Sagong, C. (2022) · Trials · doi:10.1186/s13063-022-06850-4 · Cited by 10
Traditional East Asian Herbal Medicine for Post-Stroke Insomnia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Kim, S.-H., & Lim, J.-H. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031754 · Cited by 10
“However, CBT-I referrals and implementation face several barriers, such as lack of trained practitioners, knowledge, treatment beliefs, motivation, and time [25].”
Background
Exercise as an Adjunct Treatment to Cognitive Behavior Therapy for Insomnia
Passos, G. S., Youngstedt, S. D., & Santana, M. G. (2023) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2022.09.001 · Cited by 9
Cognitive Behavioral Therapy for Insomnia Self-Management Mobile Apps: A Review of Efficacy and Quality
Rowan, A. B., Magnante, A. T., Urh, N., & Figueroa, L. M. (2024) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-023-09992-y · Cited by 9
“While CBT-I is the recommended intervention, patients with insomnia rarely receive this treatment (Koffel et al., 2018).”
Mindfulness-based therapy for insomnia in Black women: a pilot randomized controlled trial
Nam, S., Jeon, S., Ordway, M. R., Mazure, C. M., Sinha, R., Yau, L., & Iennaco, J. D. (2024) · Journal of Behavioral Medicine · doi:10.1007/s10865-024-00521-2 · Cited by 11
“The reach of CBT-I remains limited in large part to academic medical centers (Koffel et al., 2018) and insurance reimbursement for CBT-I is poor(Fields et al., 2013).”
Development of a Voice-Activated Virtual Assistant to Improve Insomnia Among Young Adult Cancer Survivors: Mixed Methods Feasibility and Acceptability Study
Groninger, H., Arem, H. E., Ayangma, L., Gong, L., Zhou, E. S., & Greenberg, D. (2024) · JMIR Formative Research · doi:10.2196/64869 · Cited by 10
“Previous studies have demonstrated the effectiveness of CBT-I among YACSs [21,22].”
The Effectiveness of Cognitive Behavioral Therapy on Insomnia Severity Among Menopausal Women: A Scoping Review
Ntikoudi, A., Owens, D. A., Spyrou, A., Evangelou, E., & Vlachou, E. D. (2024) · Life · doi:10.3390/life14111405 · Cited by 15
Over-the-counter products for insomnia in adults: A scoping review of randomised controlled trials
Salame, A., Mathew, S., Bhanu, C., Bazo‐Alvarez, J. C., Bhamra, S. K., Heinrich, M., Walters, K. R., & Frost, R. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.02.027 · Cited by 10
Cognitive-Behavioral Therapy for Insomnia (CBT-I)
Bennett, D. S. (2020) · Springer eBooks · doi:10.1007/978-3-030-44447-1_3 · Cited by 9
“I Beat Cancer to Feel Sick:” Qualitative Experiences of Sleep Disturbance in Black Breast Cancer Survivors and Recommendations for Culturally Targeted Sleep Interventions
Geiss, C., Chavez, M., Oswald, L. B., Ketcher, D., Reblin, M., Bandera, E. V., Savard, J., Zhou, E. S., Fox, R. S., Jim, H., et al. (2022) · Annals of Behavioral Medicine · doi:10.1093/abm/kaac035 · Cited by 9
“Due to the widespread shortage of available clinicians with training in administering CBT-I [15, 16], self-help mobile health (mHealth) interventions may be an efficacious strategy for providing culturally targeted and accessible care to Black cancer survivors with sleep disturbance [17].”
Background
Patient reported preferences for sleep interventions among women receiving buprenorphine for opioid use disorder
Eglovitch, M., Parlier‐Ahmad, A. B., Legge, C., Chithranjan, S., Kolli, S., Violante, S., Dzierzewski, J. M., Huhn, A. S., Wilkerson, A. K., & Martin, C. E. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1244156 · Cited by 9
Non–pharmacological interventions for sleep disruptions and fatigue after traumatic brain injury: a scoping review
Gervais, C., Hjeij, D., Fernández‐Puerta, L., & Arbour, C. (2024) · Brain Injury · doi:10.1080/02699052.2024.2318599 · Cited by 9
“For individuals dealing with sleep disorders with or without fatigue, cognitive-behavioral therapy (CBT) – a short-term form of targeted psychotherapy – is recommended as a first-line treatment (17).”
BackgroundInfluential
Promoting sleep health during pregnancy for enhancing women’s health: a longitudinal randomized controlled trial combining biological, physiological and psychological measures, Maternal Outcome after THERapy for Sleep (MOTHERS)
Meneo, D., Baldi, E., Cerolini, S., Curati, S., Bastianini, S., Berteotti, C., Simonazzi, G., Manconi, M., Zoccoli, G., Bartolo, P. D., et al. (2024) · BMC Psychology · doi:10.1186/s40359-024-01827-1 · Cited by 14
“Although CBT-I is the first line treatment for insomnia disorder, there are barriers that limits its implementation, including the lack CBT-I providers and patients’ difficulties in accessing treatment [29].”
Background
CBT-I is an efficacious, first‐line treatment for insomnia: Where we need to go from here. A commentary on the application of Tolin's criteria to cognitive behavioral therapy for insomnia.
O'Brien, E. M., & Boland, E. M. (2020) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12370 · Cited by 9
Perspective: Cognitive Behavioral Therapy for Insomnia Is a Promising Intervention for Mild Traumatic Brain Injury
Dietch, J. R., & Furst, A. J. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.530273 · Cited by 11
Effects of mindfulness‐based therapy for insomnia and a sleep hygiene/exercise programme on subjective‐objective sleep discrepancy in older adults with sleep disturbances: Exploratory secondary analysis of a randomised clinical trial
Shaif, N. A. S., Doshi, K., & Lim, J. (2022) · Journal of Sleep Research · doi:10.1111/jsr.13700 · Cited by 10
“Moreover, limited access to experienced CBTi providers remains a barrier in its implementation (Koffel et al., 2018).”
Background
Insomnia and its treatment should be given more importance
Waterman, L. Z., & Selsick, H. (2023) · British Journal of General Practice · doi:10.3399/bjgp23x734421 · Cited by 9
Efficacy of acupuncture therapy on cancer-related insomnia: a systematic review and network meta-analysis
Chen, L., Li, J., Xu, S., Liu, Z., Jiao, Y., & Zhou, Z. (2024) · Frontiers in Neurology · doi:10.3389/fneur.2024.1342383 · Cited by 10
‘Let’s talk about sleep health’ within primary care: a qualitative study of patients’ willingness to engage in psychological interventions for insomnia
Swierzbiolek, B., Oldenhof, E., Byrne, J. E. M., & Staiger, P. K. (2024) · British Journal of General Practice · doi:10.3399/bjgp.2023.0310 · Cited by 8
“30 These are mirrored by current findings, whereby participants perceived GPs lacked confidence and requisite knowledge to actively promote psychological interventions for insomnia.”
The impact of sleep education, light intervention and relaxation on sleep and mood in the elderly
Urbanová, L., Vaníček, O., Červená, K., Bartoš, A., & Evansová, K. (2024) · Chronobiology International · doi:10.1080/07420528.2024.2337007 · Cited by 12
“Many people do not address their sleep problems, or too late, so CBT-I is often combined with pharmacotherapy instead of being used as primary prevention (Koffel et al. 2018).”
Background
Acupuncture-related therapy for cancer-related insomnia: An overview of systematic reviews and meta-analysis
Guo, Z., Wang, Y., Liu, W., Huang, H., Tang, X., Wu, Z., Lu, L., Fan, B., Cui, S., & Xu, N. (2024) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2024.103074 · Cited by 8
Racial differences in treatment adherence and response to acupuncture and cognitive behavioral therapy for insomnia among Black and White cancer survivors
Liou, K. T., Garland, S. N., Meghani, S. H., Kaye, N. M., Thompson, E., Li, Q. S., & Mao, J. J. J. (2024) · Cancer Medicine · doi:10.1002/cam4.7344 · Cited by 7
“38 There are also recent efforts to tailor CBT-I to Of note, acupuncture produced greater reduction in insomnia severity and minutes awake after sleep onset among Black survivors compared with White survivors.”
Background
The Sleep Course: An inclusive trial examining the feasibility, acceptability, and preliminary efficacy of a digital sleep intervention for adults with self-reported sleep difficulties
Scott, A. J., Hathway, T., Bisby, M. A., Titov, N., & Dear, B. F. (2024) · Internet Interventions · doi:10.1016/j.invent.2024.100778 · Cited by 8
“Digital CBTi may help to overcome many of the well-known barriers to accessing evidence-based care (e.g., cost, geographical isolation) as well as the unique undersupply of health professionals trained in behavioural sleep medicine and CBTi (Koffel et al., 2018).”
Background
Safety and real-world efficacy of lemborexant in the treatment of comorbid insomnia
Katsuta, N., Takahashi, K., Kurosawa, Y., Yoshikawa, A., Takeshita, Y., Uchida, Y., Yasuda, S., Kakiuchi, C., Ito, M., & Kato, T. (2023) · Sleep Medicine X · doi:10.1016/j.sleepx.2023.100070 · Cited by 8
Comparative feasibility and preliminary efficacy of CBT for insomnia among adults seeking and not seeking addiction treatment
Miller, M. B., Freeman, L. K., Helle, A. C., Hall, N. A., DiBello, A. M., & McCrae, C. S. (2023) · Journal of Sleep Research · doi:10.1111/jsr.13969 · Cited by 9
“The demand for CBT-I also eclipses the number of trained and willing providers, with some evidence that providers uninformed or sceptical of CBT-I prioritise sleep medications and briefer, less evidence-based behavioural recommendations (i.e. sleep hygiene) instead (Koffel et al., 2018).”
Background
The Influence of Sudarshan Kriya Yoga on Sleep Quality in Indian Adults: An Open Trial Pilot Study
Kanchibhotla, D., Parekh, S. G., Harsora, P., & Kulkarni, S. (2021) · Sleep and Vigilance · doi:10.1007/s41782-021-00146-4 · Cited by 8
Cognitive Performance Trajectories Before and After Sleep Treatment Initiation in Middle-Aged and Older Adults: Results From the Health and Retirement Study
Kaufmann, C. N., Bondi, M. W., Thompson, W. K., Spira, A. P., Ancoli‐Israel, S., & Malhotra, A. (2021) · The Journals of Gerontology Series A · doi:10.1093/gerona/glab164 · Cited by 9
Poor Subjective Sleep Quality Among Patients with Cancer and Comorbid Depression: An Opportunity to Inform Screening and Intervention
Price, S. N., Hamann, H. A., Halaby, L., Trejo, J. I., Corella, F., & Weihs, K. L. (2022) · Behavioral Sleep Medicine · doi:10.1080/15402002.2022.2033243 · Cited by 8
“…these conditions, since evidence from general medical practice settings shows that clinicians tend to deprioritize insomnia treatment and to incorrectly view sleep disturbance as a symptom of depression rather than an independent condition requiring targeted treatment (Koffel et al., 2018).”
BackgroundInfluential
Cognitive behavioral therapy and acceptance and commitment therapy for insomnia: Exploring the potential benefit of psychological flexibility and self-compassion combined with behavioral strategies
Miller‐Mendes, M., Castilho, P., Clara, M. I., Clemente, V., & Gomes, A. A. (2023) · New Ideas in Psychology · doi:10.1016/j.newideapsych.2023.101013 · Cited by 11
Internet-based cognitive behavioural therapy for insomnia comorbid with chronic benign pain – A randomized controlled trial
Bothelius, K., Jernelöv, S., Kaldo, V., Lu, C., Stråle, M.-M., & Jansson‐Fröjmark, M. (2024) · Internet Interventions · doi:10.1016/j.invent.2024.100781 · Cited by 8
“Although CBT-i is widely regarded as the first-line treatment for chronic insomnia (Riemann et al., 2017; Qaseem et al., 2016), there is a need for effectiveness and implementation trials that examine potential barriers within routine care settings (Koffel et al., 2018).”
Background
Integrating traditional Chinese medicine constitutions into insomnia management: Findings from a cross-sectional study
Han, Y., Wang, Y.-Q., Shi, M.-Y., Yu, L., Cheng, X., & Zhou, Y. (2025) · Journal of Chinese Integrative Medicine · doi:10.1016/j.joim.2025.05.004 · Cited by 7
Exploring dropout in internet-delivered cognitive behavioral therapy for insomnia: A secondary analysis of prevalence, self-reported reasons, and baseline and intervention data as predictors
Simon, L., Steinmetz, L., Bendig, E., Küchler, A., Riemann, D. W., Ebert, D. D., Spiegelhalder, K., & Baumeister, H. (2025) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2025.100598 · Cited by 9
“Providing CBT-I in conventional face-to-face settings remains challenging due to the limited number of trained CBT-I providers (Koffel, Bramoweth & Ulmer 2018).”
The prevalence of insomnia in depressed adults: a systematic review
Toynbee, M., Zygmunt, D., Levett, R., Moghaddacy, S., & Pappa, S. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116888 · Cited by 9
Combination treatment for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline
Buysse, D. J., Arnedt, J. T., Buenaver, L. F., Chang, J. L., Fernández‐Mendoza, J., Patel, S. I., Zhou, E. S., Falck-Ytter, Y. T., Hyer, S., Kazmi, U., et al. (2026) · Journal of Clinical Sleep Medicine · doi:10.1007/s44470-025-00038-8 · Cited by 10
“CBT-I often requires multiple sessions with a trained pro - vider, which may not be covered or may involve long wait times [29 ].”
Factors Influencing Adherence to Insomnia and Obstructive Sleep Apnea Treatments among Veterans with Mild Traumatic Brain Injury
Kinney, A. R., Brenner, L. A., Nance, M., Mignogna, J., Cobb, A. D., Forster, J. E., Ulmer, C. S., Nakase‐Richardson, R., & Bahraini, N. H. (2024) · Behavioral Sleep Medicine · doi:10.1080/15402002.2024.2322517 · Cited by 7
“…accessing appointments (e.g., geographic distance) as well as the limited availability of trained providers made it challenging to adhere to behavioral treatments for insomnia, extending prior understanding of these factors as barriers to receiving this first-line treatment (Koffel et al., 2018).”
BackgroundSelf-citation
Digital transformation of mental health therapy by integrating digitalized cognitive behavioral therapy and eye movement desensitization and reprocessing
Wu, J., Tsai, Y.-Y., Chen, Y.-J., Hsiao, F., Hsu, C., Lin, K., & Liao, L. (2024) · Medical & Biological Engineering & Computing · doi:10.1007/s11517-024-03209-6 · Cited by 9
“CBT also benefits people who suffer from insomnia [16–23].”
Study Protocol for a Randomized Controlled Trial Assessing the Effectiveness of Personalized Computerized Cognitive Training for Individuals With Insomnia
Tapia, J. L., Puertas, F. J., & Duñabeitia, J. A. (2022) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2022.779990 · Cited by 7
Cardiac Events and Economic Burden Among Patients With Hypertension and Treated Insomnia in the USA
Wickwire, E. M., Amari, D. T., Juday, T. R., Frech, F. H., Gor, D., & Malhotra, M. (2022) · Future Cardiology · doi:10.2217/fca-2022-0009 · Cited by 7
A Practical Application Primer on Cognitive Behavioral Therapy for Insomnia for Medical Residents
Chernyak, Y. (2019) · MedEdPORTAL · doi:10.15766/mep_2374-8265.10862 · Cited by 9
Improve accessibility to evidence-based treatment for insomnia disorder
Dietch, J. R., Blok, A. C., & Zhou, E. S. (2024) · Translational Behavioral Medicine · doi:10.1093/tbm/ibae006 · Cited by 6
“Insufficient access to evidence-based insomnia treatment— including CBT-I—is related to barriers at the patient, provider, and systemic levels [15].”
Psychological interventions in behavioral sleep medicine: An overview for clinicians and psychologists
Giordano, A., Castronovo, V., & Cicolin, A. (2022) · Annals of Psychiatry and Treatment · doi:10.17352/apt.000043 · Cited by 5
Exercise Intervention on Insomnia in Patients with a Cancer: A Systematic Review of the Literature
Drozd, C., Curtit, E., Gillet, V., Jacquinot, Q., Méneveau, N., & Mougin, F. (2024) · Cancers · doi:10.3390/cancers16122241 · Cited by 9
“However, it is not available for many patients, and may be complex to implement in routine clinical practice [19].”
Background
Smartphone application‐delivered cognitive behavioural therapy for insomnia with telephone support for insomnia disorder compared to a waitlist control: a randomised clinical trial
Jansson‐Fröjmark, M., & Sunnhed, R. (2024) · Journal of Sleep Research · doi:10.1111/jsr.14363 · Cited by 6
“…interventions are still characterised by several patient barriers that prevent patients from using CBT-I, such as finding and allocating time between work, social and family leisure, or finding energy for mentally engaging with the treatment content (Kathol & Arnedt, 2016; Koffel et al., 2018).”
Sleep Deficiency in the Elderly
Pappas, J. A., & Miner, B. (2024) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2024.07.007 · Cited by 6
The impact of exercise interventions on sleep in adult populations with depression, anxiety, or posttraumatic stress: review of the current evidence and future directions
Szuhany, K. L., Sullivan, A. J., Gills, J. L., & Kredlow, M. A. (2024) · Journal of Behavioral Medicine · doi:10.1007/s10865-024-00532-z · Cited by 8
“…Johnson et al., 2006; Seow et al., 2018), anxiety disorders (25.6–33%; Johnson et al., 2006; Seow et al., 2018), and PTSD (63–92%; Ahmadi et al., 2022; Koffel et al., 2018; Milanak et al., 2019) and that insomnia may predict onset of depression and anxiety disorders (Hertenstein et al., 2019),…”
Influential
Improving sleep and learning in rehabilitation after stroke, part 2 (INSPIRES2): study protocol for a home-based randomised control trial of digital cognitive behavioural therapy (dCBT) for insomnia
Weightman, M., Robinson, B., Fallows, R., Henry, A. L., Kyle, S. D., Garratt, E., Pick, A., Teal, R., Ajina, S., Demeyere, N., et al. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-071764 · Cited by 8
Provider Perspectives on Sleep as a Determinant of Health and Housing Outcomes among Veterans Experiencing Homelessness: An Exploratory, Social-Ecological Study
Moore, E. M., Gelberg, L., Soh, M. Y., Alessi, C., & Ijadi‐Maghsoodi, R. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20095739 · Cited by 6
“While some of these barriers have been noted in the general veteran population [60], they are likely amplified in the homeless-experienced veteran population due to lack of transportation, very poor sleep environments, poor access to phone charging, and competing priorities.”
Background
Pharmacopuncture Effects on Insomnia Disorder: Protocol for a Multi-Site, Randomized, Acupuncture-Controlled, Clinical Trial
Lim, J.-H., Lee, J.-H., Kwon, C., Lee, S., Kang, C., Cho, E., Kim, H.-W., Cho, J.-H., & Kim, B.-K. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192416688 · Cited by 7
“However, some patients fail to achieve any benefit from this treatment [29], and there are some challenges in implementing CBT-I, including the lack of trained therapists, low patient motivation, and high burden of cost and time [29].”
Background
Recommendation of the European Academy for Cognitive‐Behavioural Therapy for Insomnia (CBT‐I) for high quality training for health professionals
Baglioni, C., Espie, C. A., Spiegelhalder, K., Gavriloff, D., & Riemann, D. W. (2022) · doi:10.1002/9781119891192.ch24 · Cited by 6
Insomnia and Its Non-Pharmacological Management in Older Adults
Huang, J., Antonsdottir, I. M., Wang, R., Li, M., & Li, J. (2023) · Current Geriatrics Reports · doi:10.1007/s13670-023-00397-1 · Cited by 9
“Lack of knowledge and motivation from both the clinician and patient were reported as barriers to employing CBT-I treat-ment [84].”
Determinants of Dropout From a Virtual Agent–Based App for Insomnia Management in a Self-Selected Sample of Users With Insomnia Symptoms: Longitudinal Study
Sánchez-Ortuño, M. M., Pécune, F., Coelho, J., Micoulaud‐Franchi, J., Salles, N., Auriacombe, M., Serre, F., Levavasseur, Y., de Sevin, É., Sagaspe, P., et al. (2024) · JMIR Mental Health · doi:10.2196/51022 · Cited by 7
Applying therapist-guided digital cognitive behavioral therapy for insomnia in psychiatry: a mixed-methods process evaluation
Reesen, J. E., van de Kamer, F. M., van Keeken, A., Ikelaar, S. L. C., van Oppen, P., Batelaan, N. M., Lancee, J., Someren, E. J. W. V., & van Nassau, F. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-06824-1 · Cited by 5
“…such as insurance deductibles and referral requirements; (b) clinician-related issues like inadequate training and limited familiarity with non-pharmacological treatments for insomnia, and (c) patient-related obstacles, including lack of awareness and difficulties in accessing care [17–19].”
Sleep Aid Effect and Mechanism of Semen Zizyphi Spinosae Extract Enriched With Jujuboside and Jujubogenin in Sleep‐Deprived Zebrafish
Wang, W., Li, C., Shen, L., Liu, Y., Zhou, J. R., Zheng, C., Tang, D., Xiao, F., & Xia, T. (2025) · Food Science & Nutrition · doi:10.1002/fsn3.70413 · Cited by 5
“Although the American College of Physicians has identified CBT as the first-line treatment for insomnia (Koffel et al. 2018), it has drawbacks such as high cost, long consultation time, lack of trained providers, and inability to achieve immediate results, making it difficult to implement in…”
Global perspectives on the Sleep Condition Indicator for DSM-5 insomnia disorder: a COSMIN and STARD systematic review of psychometric and diagnostic performance
Meng, R., Huang, M., Miller, C. B., Fong, D., Gregory, A. M., Pakpour, A. H., Dzierzewski, J. M., Henry, A. L., Voinescu, B., Yang, N., et al. (2025) · BMC Medicine · doi:10.1186/s12916-025-04285-7 · Cited by 5
“…21, 72, 73], has notable effects on sleep and insomnia complaints and positive effects on somatic and psychiatric comorbidity as well as quality of life, and is preferred by patients, especially using digital cognitive behavioral therapy and brief behavioral treat-ment for insomnia [60, 74–77].”
Outcomes from a combined cognitive behavioral therapy for insomnia (CBT-I) and sleep-related medication and substance use reduction treatment.
Gutierrez, G., Chowdhary, A., Hartogensis, W., Soltani, S., Chao, M. T., & Mason, A. E. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.108696 · Cited by 5
Active components in digital health interventions for sleep among adolescents: a systematic review and meta-analysis of randomized controlled trials
Salamanca-Sanabria, A., Fogel, A. M., Padmapriya, N., Chandrasekaran, M., Rodriguez, A., & Eriksson, J. G. (2025) · npj Digital Medicine · doi:10.1038/s41746-025-02152-6 · Cited by 10
Clinical and financial significance of insomnia within a large payor-provider health system
Karlin, B. E., Anderson, R. J., Rung, J. M., Drury-Gworek, C., & Barrett, T. S. (2024) · SLEEP Advances · doi:10.1093/sleepadvances/zpae054 · Cited by 5
“Yet, this gold-standard treatment remains widely unavailable in real-world treatment settings [46].”
Background
A randomized study on the effect of a wearable device using 0.75 Hz transcranial electrical stimulation on sleep onset insomnia
Simons, S. B., Provo, M., Yanoschak, A., Schmidt, C., Gerrard, I., Weisend, M. P., Anderson, C., Shimizu, R. E., & Connolly, P. M. (2024) · Frontiers in Neuroscience · doi:10.3389/fnins.2024.1427462 · Cited by 5
Clinical Management of Sleep Disturbances in Post-9/11 Men and Women Veterans: A 20-year Prospective Cohort Study
Gaffey, A. E., Haskell, S. G., Burg, M. M., Yaggi, H. K., Mattocks, K. M., Bastian, L. A., Skanderson, M., DeRycke, E. C., Hermes, E. D. A., & Brandt, C. (2025) · Journal of General Internal Medicine · doi:10.1007/s11606-025-09534-2 · Cited by 4
Effectiveness of internet‐based self‐help cognitive behavioral therapy for insomnia (CBT‐I) among community adults: A randomized controlled trial
Chan, K. L., Pau, N. H. Y., Poon, S. F. O., Lam, B. L. H., Lam, C. B., & Chan, K. K. S. (2025) · Applied Psychology Health and Well-Being · doi:10.1111/aphw.70047 · Cited by 5
“Although CBT-I is likely an effective intervention for insomnia, only a small number of individuals suffering from insomnia have the opportunity to receive it (Koffel et al., 2018).”
Thematic trends and knowledge structure on cognitive behavior therapy for insomnia: A bibliometric and visualization analysis
Xin, Q., Paudel, D., An, K., Ye, Y., Zheng, S., Chen, L., Zhang, B., & Yin, H. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.940741 · Cited by 5
Insomnia and Death Anxiety: A Theoretical Model with Therapeutic Implications
Watson, N. F. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12093250 · Cited by 5
“Both mindfulness and self-empathy are important elements of cognitive behavioral therapy: a common and effective treatment for insomnia [23].”
Background
Development and Temporal Validation of an Electronic Medical Record-Based Insomnia Prediction Model Using Data from a Statewide Health Information Exchange
Holler, E., Chekani, F., Ai, J., Meng, W., Khandker, R. K., Miled, Z. B., Owora, A. H., Dexter, P. R., Campbell, N. L., Solid, C. A., et al. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12093286 · Cited by 5
“However, CBT-I is often less accessible to patients than pharmacotherapy and requires sustained patient engagement for benefits to be realized [14].”
Background
Insomnia among community members in Florida: Associations with demographics, health conditions, and social support
Fidler, A. L., Chaudhari, P., Sims, V., Payne-Murphy, J. C., Fischer, J., & Cottler, L. B. (2023) · Journal of Clinical and Translational Science · doi:10.1017/cts.2023.536 · Cited by 5
“Given the substantial public health burden of insomnia [2,4–8], there is a crucial need to increase awareness of effective insomnia treatments and to continue advancing implementation research [55].”
Background
Efficacy and safety of digital therapeutic application of Sleep Index‐Based Treatment for Insomnia ( dSIBT‐I ): a pilot study
Chung, S., Cho, I., Kim, J., Lee, D., Cho, E., Choi, J. M., Ha, T. K., Lee, Y. J., Kim, J. H., & Choi, J. H. (2023) · Journal of Sleep Research · doi:10.1111/jsr.14039 · Cited by 5
“The relatively low availability of CBT-I is another aspect to consider (Koffel et al., 2018).”
Background
Development of a hybrid sleep and physical activity improvement intervention for adults with osteoarthritis-related pain and sleep disturbance: a focus group study with potential users
Whibley, D., Stelfox, K., Henry, A. L., Tang, N. K. Y., & Kratz, A. L. (2021) · British Journal of Pain · doi:10.1177/20494637211026049 · Cited by 5
“In addition, digital delivery may overcome many of the barriers associated with accessing in-person CBT-I, including limited numbers and poor geographical distribution of trained providers.(29) Sleepio is one such fully automated (i.”
Background
Referral process to further evaluate poor sleep in breast cancer survivors
Otte, J. L., Chernyak, Y., Johns, S. A., Jackson, L. S., Ludwig, K. K., Dodson, J., Manchanda, S., Bufink, E., & Draucker, C. B. (2022) · Cancer Medicine · doi:10.1002/cam4.4578 · Cited by 4
Management of Chronic Insomnia Using Cognitive Behavior Therapy for Insomnia (CBT-I) During COVID-19 Pandemic: Does One Shoe Fit All?
Pal, A., Joshi, T., Basu, A., & Gupta, R. M. (2022) · Sleep and Vigilance · doi:10.1007/s41782-022-00197-1 · Cited by 5
“In addition, because of preconceptions, many physicians decide on behalf of patients and do not offer CBT-I to their patients [32, 37].”
BackgroundInfluential
Effectiveness of Cognitive Behavioral Therapy for Sleep Disorder: An overview of Systematic Review
Lee, J. W., Yeo, J. J., Kim, K. S., & Hyun, M. K. (2022) · 대한한의학회지 · doi:10.13048/jkm.22021 · Cited by 4
The Use of Evaluation Panels During the Development of a Digital Intervention for Veterans Based on Cognitive Behavioral Therapy for Insomnia: Qualitative Evaluation Study
Ryan, A. T., Brenner, L. A., Ulmer, C. S., Mackintosh, M., & Greene, C. J. (2023) · JMIR Formative Research · doi:10.2196/40104 · Cited by 5
“Despite these efforts, the availability of trained CBT-I providers continues to limit the number of individuals who can receive CBT-I treatment, particularly outside of the VHA, where many veterans receive their health care [22,23].”
BackgroundSelf-citation
Valerian for Insomnia on Subjective and Objective Sleep Parameters: a Meta-analysis of Randomized Controlled Trials
Zhang, X., Lu, Y., Lv, F., Hu, Y., Yao, Z., Wu, Y., Lian, F., Yang, J., & Xu, X. (2023) · Current Sleep Medicine Reports · doi:10.1007/s40675-023-00259-4 · Cited by 5
“Although cognitive behavioral therapy for insomnia (CBT-I) is recommended as a firstline treatment for chronic insomnia [7], some patients may find it difficult to implement behavioral/psychological treatments because of the accessibility and cost-effectiveness of these treatments [8].”
Background
Internetbasierte kognitive Verhaltenstherapie der Insomnie und Albtraumstörung
Frase, L., Duss, S. B., Gieselmann, A., Penzel, T., Wetter, T. C., & Pollmächer, T. (2019) · Der Nervenarzt · doi:10.1007/s00115-019-00803-0 · Cited by 6
Integrating interventions based on cognitive behavioural therapy for insomnia in physical therapist practice for individuals with chronic pain and insomnia: Identifying barriers and formulating implementation strategies
Markaryan, M., Labie, C., Verschueren, S., Assche, D. V., Nijs, J., Mairesse, O., Malfliet, A., de Vlam, K., Runge, N., Caeyers, N., et al. (2025) · Brazilian Journal of Physical Therapy · doi:10.1016/j.bjpt.2025.101243 · Cited by 5
“39 Access to CBT-I in primary care is problematic worldwide, 40 – 42 often leaving insomnia unaddressed in individuals with chronic pain and insomnia.”
Cannabinol for Acute Treatment of Insomnia Disorder in a Randomized Placebo‐Controlled Crossover Trial
Lavender, I., Marshall, N. S., McCartney, D., Cho, G., Irwin, C. G., Suraev, A. S., Gordon, R., Arnold, J. C., D'Rozario, A. L., Gordon, C. J., et al. (2026) · Journal of Sleep Research · doi:10.1111/jsr.70284 · Cited by 4
“Cognitive-behavioural therapy for insomnia (CBTi) has demonstrated efficacy (Trauer et al. 2015; van Straten et al. 2018) but faces accessibility and scalability issues (Koffel et al. 2018) and has significant attrition when delivered via digital means (Zachariae et al. 2016).”
Veteran Acceptance of Sleep Health Information Technology: a Mixed-Method Study
Kaitz, J. E., Robinson, S. A., Petrakis, B. A., Reilly, E. D., Chamberlin, E. S., Wiener, R. S., & Quigley, K. S. (2022) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-022-00287-x · Cited by 4
“Despite these eﬀorts, CBT-I remains underutilized within the VA (Koﬀel et al., 2018a).”
Influential

Authors: Koffel, E., Bramoweth, A. D., & Ulmer, C. S.
Affiliations: University of Minnesota (US)
VA Pittsburgh Healthcare System (US)
Duke University (US)
Corresponding author: Koffel, Erin
ORCID: Koffel, Erin
Bramoweth, Adam D.
Ulmer, Christi S.
Venue: Journal of General Internal Medicine
Publisher: Springer Science and Business Media LLC
Published: 2018-04-04
Volume: 33
Issue: 6
Pages: 955-962
ISSN: 0884-8734 (ISSN-L)
1525-1497
DOI: 10.1007/s11606-018-4390-1
PMC: PMC5975165
OpenAlex: W2795657325
Cited by: 391
References: 82
Citations by year: 2026: 66 · 2025: 70 · 2024: 69 · 2023: 62 · 2022: 49 · 2021: 27 · 2020: 32 · 2019: 11 · 2018: 4
FWCI: 2.95
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
Locations: Journal of General Internal Medicine (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Veterans Affairs
University of Minnesota
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
Keywords: cognitive behavioral therapy for insomnia, insomnia, barriers to treatment access, primary care referral, behavioral sleep medicine, sleep screening, patient engagement, treatment beliefs, implementation research, guideline-concordant care, hypnotic dependence
MeSH terms: Health Services Accessibility, Humans, Sleep Initiation and Maintenance Disorders, Patient Acceptance of Health Care, Primary Health Care, Cognitive Behavioral Therapy

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Increasing access to and utilization of cognitive behavioral therapy for insomnia (CBT-I): a narrative review

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Self-check

Citations

Cites

Cited by

Related

Metadata

Record

About these checks