Cognitive Behavioral Therapy for Chronic Insomnia: State of the Science Versus Current Clinical Practices
Abstract
Editorials4 August 2015Cognitive Behavioral Therapy for Chronic Insomnia: State of the Science Versus Current Clinical PracticesCharles M. Morin, PhDCharles M. Morin, PhDFrom Université Laval, Québec, Québec, Canada.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-1246 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In this issue, Trauer and colleagues (1) report important findings from a systematic review and meta-analysis of 20 randomized, controlled trials (n = 1162 participants) evaluating the efficacy of cognitive behavioral therapy for insomnia (CBT-i). The results indicate that CBT-i, a brief, pragmatic, nonpharmacologic intervention, produces significant improvements in sleep, with no adverse outcomes. More important, the improvements were well-sustained over time. This article adds to the already strong evidence base supporting the short- and long-term efficacy of CBT-i for persistent insomnia (2, 3). Given the high prevalence and heavy personal and societal burden of insomnia, as well as the shortcomings ...References1. Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, Cunnington D. Cognitive behavioral therapy for chronic insomnia. A systematic review and meta-analysis. Ann Intern Med. 2015;163:191-204. doi:10.7326/M14-2841 LinkGoogle Scholar2. Morin CM, Bootzin RR, Buysse DJ, Edinger JD, Espie CA, Lichstein KL. Psychological and behavioral treatment of insomnia: update of the recent evidence (1998–2004). Sleep. 2006;29:1398-414. [PMID: 17162986] CrossrefMedlineGoogle Scholar3. National Institutes of Health. National Institutes of Health State of the Science Conference statement on Manifestations and Management of Chronic Insomnia in Adults, June 13-15, 2005. Sleep. 2005;28:1049-57. [PMID: 16268373] MedlineGoogle Scholar4. Manber R, Edinger JD, Gress JL, San Pedro-Salcedo MG, Kuo TF, Kalista T. Cognitive behavioral therapy for insomnia enhances depression outcome in patients with comorbid major depressive disorder and insomnia. Sleep. 2008;31:489-95. [PMID: 18457236] CrossrefMedlineGoogle Scholar5. Vitiello MV, McCurry SM, Shortreed SM, Balderson BH, Baker LD, Keefe FJ, et al. Cognitive-behavioral treatment for comorbid insomnia and osteoarthritis pain in primary care: the Lifestyles randomized controlled trial. J Am Geriatr Soc. 2013;61:947-56. [PMID: 23711168] doi:10.1111/jgs.12275 CrossrefMedlineGoogle Scholar6. Savard J, Ivers H, Savard MH, Morin CM. Is a video-based cognitive behavioral therapy for insomnia as efficacious as a professionally administered treatment in breast cancer? Results of a randomized controlled trial. Sleep. 2014;37:1305-14. [PMID: 25083010] doi:10.5665/sleep.3918 CrossrefMedlineGoogle Scholar7. Suka M, Yoshida K, Sugimori H. Persistent insomnia is a predictor of hypertension in Japanese male workers. J Occup Health. 2003;45:344-50. [PMID: 14676413] CrossrefMedlineGoogle Scholar8. Daley M, Morin CM, LeBlanc M, Grégoire JP, Savard J, Baillargeon L. Insomnia and its relationship to health-care utilization, work absenteeism, productivity and accidents. Sleep Med. 2009;10:427-38. [PMID: 18753000] doi:10.1016/j.sleep.2008.04.005 CrossrefMedlineGoogle Scholar9. Schutte-Rodin S, Broch L, Buysse D, Dorsey C, Sateia M. Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med. 2008;4:487-504. [PMID: 18853708] CrossrefMedlineGoogle Scholar10. Morin CM, Vallières A, Guay B, Ivers H, Savard J, Mérette C, et al. Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: a randomized controlled trial. JAMA. 2009;301:2005-15. [PMID: 19454639] doi:10.1001/jama.2009.682 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Charles M. Morin, PhDAffiliations: From Université Laval, Québec, Québec, Canada.Acknowledgment: The author thanks Dr. Lynda Bélanger for her comments on an earlier draft of this manuscript.Grant Support: Preparation of this manuscript was supported in part by research grants from the Canadian Institutes of Health Research (MT-42504) and the National Institute of Mental Health (MH-091053).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-1246.Corresponding Author: Charles M. Morin, PhD, Université Laval, école de psychologie, 2325 rue des Bibliothèques, Québec, Québec G1V 0A6, Canada; e-mail, cmorin@psy.ulaval.ca.This article was published online first at www.annals.org on 9 June 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCognitive Behavioral Therapy for Chronic Insomnia James M. Trauer , Mary Y. Qian , Joseph S. Doyle , Shantha M.W. Rajaratnam , and David Cunnington Metrics Cited byComparative efficacy of onsite, digital, and other settings for cognitive behavioral therapy for insomnia: a systematic review and network meta-analysisCosts associated with treatment o
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CBT-I implementation in community and primary care settings remains limited.
“However, its implementation in community and primary care settings remains limited because CBT-I is intensive and requires administration by highly trained therapists; (Morin, 2015)”
From Sleep health: Reciprocal regulation of sleep and innate immunity (2017) · cites this paper as Morin, 2015
Cites
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 · see citing works
Psychological and behavioral treatment of insomnia: update of the recent evidence (1998-2004)
Morin, C. M., Bootzin, R. R., Buysse, D. J., Edinger, J. D., Espie, C. A., & Lichstein, K. L. (2006) · Sleep · doi:10.1093/sleep/29.11.1398 · Cited by 1,345 · see citing works
Self-citationCognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis
Trauer, J. M., Qian, M. Y., Doyle, J. S., Rajaratnam, S. M. W., & Cunnington, D. (2015) · Annals of Internal Medicine · doi:10.7326/m14-2841 · Cited by 1,053 · see citing works
Manber, R., Edinger, J. D., Gress, J. L., Pedro-Salcedo, M. G. S., Kuo, T. F., & Kalista, T. (2008) · Sleep · doi:10.1093/sleep/31.4.489 · Cited by 868 · see citing works
Morin, C., Vallières, A., Guay, B., Ivers, H., Savard, J., Mérette, C., Bastien, C., & Baillargeon, L. (2009) · Journal of the American Medical Association (JAMA) · doi:10.1001/jama.2009.682 · Cited by 766 · see citing works
Self-citationNational Institutes of Health State of the Science Conference Statement
(2005) · Sleep · doi:10.1093/sleep/28.9.1049 · Cited by 745 · see citing works
Daley, M. M. R., Morin, C. M., LeBlanc, M., Grégoire, J., Savard, J., & Baillargeon, L. (2008) · Sleep Medicine · doi:10.1016/j.sleep.2008.04.005 · Cited by 441 · see citing works
Self-citationPersistent Insomnia is a Predictor of Hypertension in Japanese Male Workers
Suka, M., Yoshida, K., & Sugimori, H. (2003) · Journal of Occupational Health · doi:10.1539/joh.45.344 · Cited by 246 · see citing works
Vitiello, M. V., McCurry, S. M., Shortreed, S. M., Balderson, B. H., Baker, L. D., Keefe, F. J., Rybarczyk, B. D., & Von Korff, M. (2013) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12275 · Cited by 165 · see citing works
Savard, J., Ivers, H., Savard, M.-H., & Morin, C. M. (2014) · Sleep · doi:10.5665/sleep.3918 · Cited by 136 · see citing works
Self-citation
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Sleep health: Reciprocal regulation of sleep and innate immunity
Irwin, M. R., & Opp, M. R. (2017) · Neuropsychopharmacology · doi:10.1038/npp.2016.148 · Cited by 624 · see citing works
Irwin, M. R., Olmstead, R. E., Carrillo, C., Sadeghi, N., Nicassio, P. M., Ganz, P. A., & Bower, J. E. (2017) · Journal of Clinical Oncology · doi:10.1200/jco.2016.71.0285 · Cited by 211 · see citing works
Efficacy of cognitive behavioral therapy for insomnia in breast cancer: A meta-analysis
Ma, Y., Hall, D. L., Ngo, L. H., Liu, Q., Bain, P. A., & Yeh, G. Y. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2020.101376 · Cited by 151 · see citing works
Simon, L., Steinmetz, L., Feige, B., Benz, F., Spiegelhalder, K., & Baumeister, H. (2023) · Scientific Reports · doi:10.1038/s41598-023-28853-0 · Cited by 135 · see citing works
Help-seeking behaviors for insomnia in Hong Kong Chinese: a community-based study
Liu, Y., Zhang, J., Lam, S. P., Yu, M. W. M., Li, S. X., Zhou, J., Chan, J. W. Y., Chan, N. Y., Li, A. M., & Wing, Y. K. (2016) · Sleep Medicine · doi:10.1016/j.sleep.2016.01.006 · Cited by 77 · see citing works
Kallestad, H., Scott, J. L., Vedaa, Ø., Lydersen, S., Vethe, D., Morken, G., Stiles, T. C., Sivertsen, B., & Langsrud, K. (2020) · SLEEP · doi:10.1093/sleep/zsab185 · Cited by 64 · see citing works
Nonpharmacologic Management of Chronic Insomnia.
Maness, D. L., & Khan, M. (2015) · PubMed · Cited by 57 · see citing works
Behrendt, D., Ebert, D. D., Spiegelhalder, K., & Lehr, D. (2020) · Journal of Medical Internet Research · doi:10.2196/13346 · Cited by 52 · see citing works
Perrault, A. A., Pomares, F. B., Smith, D., Cross, N. E., Gong, K., Maltezos, A., McCarthy, M., Madigan, E., Tarelli, L., McGrath, J. J., et al. (2022) · Sleep Medicine · doi:10.1016/j.sleep.2022.05.010 · Cited by 50 · see citing works
Salwen‐Deremer, J. K., Smith, M. T., & Finan, P. H. (2016) · SLEEP · doi:10.1093/sleep/zsw064 · Cited by 39 · see citing works
Advise non-pharmacological therapy as first line treatment for chronic insomnia
Soong, C., Burry, L. D., Greco, M., & Tannenbaum, C. (2021) · BMJ · doi:10.1136/bmj.n680 · Cited by 38 · see citing works
College students’ using marijuana to sleep relates to frequency, problematic use, and sleep problems
Drazdowski, T. K., Kliewer, W. L., & Marzell, M. (2019) · Journal of American College Health · doi:10.1080/07448481.2019.1656634 · Cited by 37 · see citing works
Poor Sleep in Inflammatory Bowel Disease Is Reflective of Distinct Sleep Disorders
Salwen-Deremer, J. K., Smith, M. T., Haskell, H. G., Schreyer, C., & Siegel, C. A. (2022) · Digestive Diseases and Sciences · doi:10.1007/s10620-021-07176-y · Cited by 35 · see citing works
Gkintoni, E., Vassilopoulos, S. P., Nikolaou, G., & Boutsinas, B. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14072265 · Cited by 34 · see citing works
Hall, D. L., Arditte Hall, K. A., Gorman, M. J., Comander, A., Goldstein, M. R., Cunningham, T. J., Wieman, S., Mizrach, H. R., Juhel, B. C., Li, R., et al. (2022) · Cancer · doi:10.1002/cncr.34066 · Cited by 31 · see citing works
Drake, C. L. (2015) · SLEEP · doi:10.5665/sleep.5304 · Cited by 28 · see citing works
Preliminary evidence linking complex-PTSD to insomnia in a sample of Yazidi genocide survivors
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Factors associated with self-rated health in primary care
Mildestvedt, T., Herikstad, V. V., Undheim, I., Bjorvatn, B., & Meland, E. (2018) · Scandinavian Journal of Primary Health Care · doi:10.1080/02813432.2018.1499590 · Cited by 27 · see citing works
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Chaiard, J., & Weaver, T. E. (2019) · Journal of Nursing Scholarship · doi:10.1111/jnu.12515 · Cited by 17 · see citing works
Bentley, T. G. K., Castillo, D., Sadeghi, N., Piber, D., Carroll, J., Olmstead, R. E., & Irwin, M. R. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-07619-w · Cited by 17 · see citing works
Salwen‐Deremer, J. K., Siegel, C. A., & Smith, M. T. (2020) · Crohn s & Colitis 360 · doi:10.1093/crocol/otaa052 · Cited by 15 · see citing works
Tai Chi exercise for sleep problems in older adults
Si, Y., Wang, C., Zheng, J., Guo, Y., Xu, G., & Ma, Y. (2019) · Medicine · doi:10.1097/md.0000000000017556 · Cited by 11 · see citing works
Meaklim, H., Abbott, J.-A., Kennedy, G. A., Murray, G., Klein, B., & Rehm, I. C. (2018) · Australian Psychologist · doi:10.1111/ap.12374 · Cited by 11 · see citing works
Prescription Patterns of Sedative Hypnotic Medications in the Military Health System
Jean, R. T., Hou, Y., Masterson, J., Kress, A. T., & Mysliwiec, V. (2019) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7840 · Cited by 10 · see citing works
Low, S. L. K., Cheema, B., Tan, H. Y., Birling, Y., & Zhu, X.-S. (2020) · Integrative Cancer Therapies · doi:10.1177/1534735420977671 · Cited by 8 · see citing works
Motivations for Prescription Drug Misuse Related to Mental Health Problems in Adults
Drazdowski, T. K., Schulte, M. T., Wolitzky-Taylor, K. B., Schaper, H., & Chapman, J. E. (2021) · Substance Use & Misuse · doi:10.1080/10826084.2021.2012687 · Cited by 8 · see citing works
Scott, J. L., Vedaa, Ø., Sivertsen, B., Langsrud, K., & Kallestad, H. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.01.054 · Cited by 7 · see citing works
Innovation in the Treatment of Insomnia in Breast Cancer Survivors
Irwin, M. R. (2018) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djy006 · Cited by 6 · see citing works
Symptoms and Symptom Management in Survivorship Patients
Klein, G., & Jodocy, D. (2021) · Springer eBooks · doi:10.1007/978-3-030-78648-9_10 · Cited by 5 · see citing works
Vallim, J. R. D. S., Pires, G. N., Bonaldi, R. R., Zanini, M. A., Soster, L. A., Garbuio, S. A., & Sousa, K. M. M. (2023) · Sleep Epidemiology · doi:10.1016/j.sleepe.2023.100061 · Cited by 5 · see citing works
Barbaux, L., Cross, N. E., Perrault, A. A., Essounni, M., Desrosiers, C., Clerc, D., Andriamampionona, F., Lussier, D., Tannenbaum, C., Guimond, A., et al. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106826 · Cited by 3 · see citing works
Insomnia remission and improvement of bodily pain in older adults: a randomized clinical trial
Bjurstrom, M. F., Olmstead, R., & Irwin, M. R. (2025) · PAIN Reports · doi:10.1097/pr9.0000000000001243 · Cited by 3 · see citing works
Robert, C., Villain, C., Fayard, F., & Urbain, F. (2019) · Médecine du Sommeil · doi:10.1016/j.msom.2019.09.001 · Cited by 3 · see citing works
Alzahrani, A. A., Al-Essa, M., Alharbi, F. M., & Alotaibi, T. M. (2025) · Cureus · doi:10.7759/cureus.95823 · Cited by 2 · see citing works
Knowledge mapping of chronic insomnia: a bibliometric analysis (2000–2023)
Wu, K., & Zhang, Z. (2024) · Sleep And Breathing · doi:10.1007/s11325-024-03049-6 · Cited by 2 · see citing works
Integration of cognitive behavioral therapy for insomnia.
Taylor, D. J., & Dietch, J. R. (2018) · Journal of Psychotherapy Integration · doi:10.1037/int0000133 · Cited by 2 · see citing works
Holzinger, B., Nierwetberg, F., & Klösch, G. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.733911 · Cited by 2 · see citing works
Sessle, B. J., Adachi, K., Yao, D., Suzuki, Y., & Lavigne, G. J. (2019) · Springer eBooks · doi:10.1007/978-3-319-72303-7_40 · Cited by 2 · see citing works
Zhang, Y., Cao, Z., Ye, J., Dai, G., Qin, S., Wang, X., Wu, W., & Liu, C. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1499361 · Cited by 1 · see citing works
Hodge, B., Richert, E., Schmitz, L., Íslind, A. S., Leppänen, T., McNicholas, W. T., Arnardóttir, E. S., & Pires, G. N. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.108676 · Cited by 1 · see citing works
Sessle, B. J., Adachi, K., Yao, D., Suzuki, Y., & Lavigne, G. J. (2017) · Springer eBooks · doi:10.1007/978-3-319-28100-1_40-1 · Cited by 1 · see citing works
Comparing Participants’ Satisfaction with Behavioral Therapies for Chronic Insomnia
Sidani, S., Epstein, D. R., Fox, M. T., & Collins, L. J. (2018) · Science of Nursing and Health Practices · doi:10.31770/2561-7516.1016 · Cited by 1 · see citing works
Cognitive-Behavioral Therapy for Insomnia
Hall, D. L., Gorman, M. J., Finkelstein‐Fox, L., Wieman, S. T., Mizrach, H. R., & Park, E. R. (2023) · Current clinical psychiatry · doi:10.1007/978-3-031-29368-9_22 · Cited by 1 · see citing works
Sessle, B. J., Adachi, K., Yao, D., Suzuki, Y., & Lavigne, G. J. (2017) · Springer eBooks · doi:10.1007/978-3-319-28100-1_40-2 · Cited by 1 · see citing works
Cognitive Behavioral Therapy for Chronic Insomnia
van den Noort, M., Bosch, P., Staudte, H., & Lim, S. (2016) · Annals of Internal Medicine · doi:10.7326/l15-0483 · Cited by 1 · see citing works
Prediktion av utfall utifrån terapeutskattningar tidigt i internetförmedlad KBT mot insomni
von Plauen, R. (2015) · KTH Publication Database DiVA (KTH Royal Institute of Technology)
Landmark, L., Smits, M. J. B., Fors, E. A., Dahm, Ø. N., Kennair, L. E. O., & Jacobsen, H. B. (2026) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2025-0050
Betz, L. T., Göder, R., Jacob, G. A., & Riemann, D. W. (2026) · Behaviour Research and Therapy · doi:10.1016/j.brat.2026.105075
Li, M., Huang, P., Yunshan, L., Yang, M., Deng, F., Ji, K., Chen, L., Liu, C., Rong, P., Lee, H. W., et al. (2026) · Acupuncture and Herbal Medicine · doi:10.1097/hm9.0000000000000206
- Authors
- Morin, C. M.
- Affiliations
- Université Laval (CA)
- Corresponding author
- Morin, Charles M.
- ORCID
- Morin, Charles M.
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2015-08-04
- Volume
- 163
- Issue
- 3
- Pages
- 236-237
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W1560905450
- Cited by
- 52
- References
- 10
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 1 · 2023: 3 · 2022: 3 · 2021: 7 · 2020: 3 · 2019: 7 · 2018: 7 · 2017: 5 · 2016: 4 · 2015: 3
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Corpus Université Laval (Université Laval) (submittedVersion)
- Funders
- Canadian Institutes of Health Research (MT42504)
- National Institute of Mental Health (R01MH091053, MH-091053)
- 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
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- cognitive behavioral therapy for insomnia, chronic insomnia, non-pharmacological treatment, treatment efficacy, clinical practice, knowledge-practice gap, sleep disorders, comorbid depression, medication adherence, relapse prevention
- MeSH terms
- Humans, Sleep Initiation and Maintenance Disorders, Cognitive Behavioral Therapy
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