Revisiting the Psychobiological Inhibition Model: a conceptual framework for understanding and treating insomnia using cognitive and behavioural therapeutics ( CBTx )
Open accessAbstract
Summary: Sleep is a biological imperative, so one might wonder “what has psychology got to do with it?” A person's behaviours, thoughts, emotions and interactions with the environment inevitably serve for good, or for ill, as the “setting conditions” for the expression of sleep. Put simply, although sleep is not a psychological phenomenon, sleep has crucial behavioural dependencies. Consequently, the Psychobiological Inhibition Model can embrace numerous, potentially interacting, pathways to the persistence of this ubiquitous disorder, providing an overarching conceptual framework for why and how insomnia develops. The clinical guideline treatment for chronic insomnia is cognitive behavioural therapy. Although typically delivered as “talking therapy”, cognitive behavioural therapy is not some form of “psychobabble”. Rather, the Psychobiological Inhibition Model framework for insomnia articulates how specific techniques can correct the various ways in which the expression of normal sleep and circadian brain–behaviour relationships have become disrupted. Indeed, cognitive behavioural therapy is best conceived of as an approach to treatment rather than being one specific agent. A shift in emphasis towards a cognitive and behavioural therapeutics formulary would provide improved impetus to understanding of how insomnia develops, and of how it may best be treated in any given patient.
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Insomnia and Inhibitory Control: Linking Electroencephalography and Cued Go/NoGo Task
Li, X., Yu, S., & Li, S. X. (2025) · Springer eBooks · doi:10.1007/978-3-031-73368-0_171
The Sleep Acceptance Scale (SAS): Development, psychometric properties, and applications
Ferreira, R. E. R., Carmo, M., Paulos‐Guarnieri, L., & Pires, M. L. N. (2025) · Behavioral Sleep Medicine · doi:10.1080/15402002.2025.2555864
When CBT ‐I Falls Short: Why Solution‐Focused Therapy Deserves Attention in Insomnia Research
Carpi, M., & Szkody, E. M. (2025) · Journal of Sleep Research · doi:10.1111/jsr.70216
Neurocognitive deficits in controlling aversive memory among insomnia disordersPreprint
Zuo, X., Lin, X., Yao, Z., Chen, D., Liu, J., Guo, S., Yue, W. W. Y., Yang, Y., Wang, W., Feng, H., et al. (2026) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.64898/2026.03.04.709020
From night-to-night and from person-to-person: dynamic phenomena of insomnia
Klau, M. M., Lancee, J., Looman, M. I., van der Maas, H. L. J., Visser, R. M., & Blanken, T. F. (2026) · SLEEP Advances · doi:10.1093/sleepadvances/zpag035
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The Glasgow Sleep Effort Scale: A reliability generalization meta-analysis of internal consistency
Gaspar, V., Dias, S. F., Broomfield, N. M., Espie, C. A., & Marques, D. R. (2026) · Sleep Medicine · doi:10.1016/j.sleep.2026.109182
Self-citationPrise en charge de l’insomnie : cognitions
Brion, A. (2025) · Elsevier eBooks · doi:10.1016/b978-2-294-78711-9.00039-6
Espie, C. A., Tse, K. Y. K., & Malaffo, M. (2026) · Behavioral Sleep Medicine · doi:10.1080/15402002.2026.2724278
Self-citation
- Authors
- Espie, C. A.
- Affiliations
- University of Oxford (GB)
- Corresponding author
- Espie, Colin A.
- ORCID
- Espie, Colin A.
- Venue
- Journal of Sleep Research
- Publisher
- Wiley
- Published
- 2023-02-06
- Volume
- 32
- Issue
- 6
- Pages
- e13841-e13841
- ISSN
- 0962-1105 (ISSN-L)
- 1365-2869
- OpenAlex
- W4319334323
- Cited by
- 45
- References
- 64
- Citations by year
- 2026: 10 · 2025: 15 · 2024: 13 · 2023: 7
- FWCI
- 1.90
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Sleep Research (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Institute for Health and Care Research
- Department of Health and Social Care
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- insomnia, cognitive behavioral therapy, insomnia treatment, sleep regulation, circadian rhythm, brain-behavior relationship, conceptual framework
- MeSH terms
- Brain, Cognition, Humans, Inhibition, Psychological, Sleep Initiation and Maintenance Disorders, Sleep
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