Cognitive Behavior Therapy for Insomnia: state of the science or a stated science?

Even a cursory glance over the literature will tell you that Cognitive Behavioral Therapy for Insomnia (CBT-I) is a well-researched intervention. With a myriad of reviews and meta-analyses to draw upon, we can also say with a great deal of confidence that CBT-I is largely effective, efficacious, and durable [1]. In fact CBT-I has long been considered the first line treatment for chronic insomnia among several international organizations (e.g. National Institutes of Health, British Association for Psychopharmacology). What’s more, CBT-I has been shown effective for insomnia comorbid with a variety of physical and psychiatric conditions, and appears to be at least comparable to pharmacotherapy in the short-term and potentially superior in the longer term [2], [3] and [4]. With such an abundance of evidence, one question remains – is there a need for more CBT-I studies? The answer is most definitely yes, although with some qualification. To determine the future of this ‘much stated science’ we must ask ourselves what we know about CBT-I, good and bad, and what we need know to make it even better.