CBT-i (Cognitive Behavioral Therapy for Insomnia)
treatmentCBT-i is a behavioral treatment, not a medication. Somryst is FDA-cleared as a prescription digital therapeutic. Other programs are not individually FDA-regulated as medical devices.
Cost information
$0 - $300/program
CBT-i (cognitive behavioral therapy for insomnia) is the treatment US medical guidelines recommend first for chronic insomnia in adults, before sleeping pills, and it costs anywhere from nothing (two free VA apps) to $297 per 28 days for a coached app like Sleep Reset, with therapist visits priced per session. It is usually 4 to 8 sessions over about 6 to 8 weeks that change your sleep schedule, bedtime habits and thinking about sleep. The American College of Physicians gives it a strong recommendation as the initial treatment, and the American Academy of Sleep Medicine gives multicomponent CBT-i its only strong recommendation among behavioral treatments. You can do it with a clinician in person, by phone or online, or through an app; two prescription apps, Somryst and SleepioRx, are FDA-cleared.
Dosage Format
Typically 6-8 weekly sessions lasting 30-60 minutes each. Digital programs may be self-paced over 6-9 weeks. Involves structured sleep diary tracking, stimulus control, sleep restriction, and cognitive restructuring techniques.
Type
Treatment
Who to discuss it with
Adults with chronic insomnia who want a long-term solution without ongoing medication use, or as a complement to medication-based treatment
Key distinction
The American Academy of Sleep Medicine and American College of Physicians both recommend CBT-i as the first-line treatment for chronic insomnia — ahead of any medication.
Updated · By Treatment Comparison Editorial Team · Sources and scope
Sources: American College of Physicians (Ann Intern Med, 2016): ACP 2016 insomnia guideline · American Academy of Sleep Medicine (J Clin Sleep Med, 2021): AASM 2021 behavioral treatment guideline · National Heart, Lung, and Blood Institute (NIH): NHLBI insomnia treatment · FDA: FDA Somryst 510(k) · American Academy of Sleep Medicine: AASM on SleepioRx clearance · Sleep Review (May 24, 2023): Sleep Review on Nox Health and Somryst · U.S. Department of Veterans Affairs: VA CBT-i Coach · U.S. Department of Veterans Affairs: VA Insomnia Coach
What the guidelines recommend
- ACP 2016, recommendation 1: all adults with chronic insomnia disorder should receive CBT-i as the initial treatment (strong recommendation, moderate-quality evidence).
- ACP 2016, recommendation 2: if CBT-i alone is unsuccessful, decide with a clinician whether to add medicine, weighing benefits, harms and costs of short-term use (weak recommendation, low-quality evidence).
- AASM 2021: strong recommendation for multicomponent CBT-i; conditional recommendations for brief therapies, stimulus control, sleep restriction and relaxation; sleep hygiene alone is suggested against as a treatment.
- NHLBI: CBT-i is usually recommended as the first treatment option for long-term insomnia.
Sources: American College of Physicians (Ann Intern Med, 2016): ACP 2016 insomnia guideline · American Academy of Sleep Medicine (J Clin Sleep Med, 2021): AASM 2021 behavioral treatment guideline · National Heart, Lung, and Blood Institute (NIH): NHLBI insomnia treatment
CBT-i formats and what they cost
| Format | Example | Prescription needed | Published cost |
|---|---|---|---|
| Therapist, online or in person | MDLIVE talk therapy (CBT); ask for CBT-i training | No | $0 to $179 first visit, $140 follow-ups before insurance (MDLIVE) |
| Coached app | Sleep Reset, 28-day program | No | $19 one-week trial, then $297 per 28 days; HSA/FSA eligible at checkout |
| Government app, self-guided | VA Insomnia Coach, daily for 5 weeks | No | Free (App Store) |
| Government app, used with a provider | VA CBT-i Coach | No, but meant for use with a provider | Free (App Store) |
| Prescription digital therapeutic | Somryst (adults 22+); SleepioRx (adults, 90 days) | Yes | Not published; ask the prescriber or insurer |
Sources: FDA: FDA Somryst 510(k) · American Academy of Sleep Medicine: AASM on SleepioRx clearance · U.S. Department of Veterans Affairs: VA CBT-i Coach · U.S. Department of Veterans Affairs: VA Insomnia Coach · Apple App Store (seller: US Department of Veterans Affairs): CBT-i Coach App Store listing · Apple App Store (seller: US Department of Veterans Affairs): Insomnia Coach App Store listing · Sleep Reset: Sleep Reset pricing · MDLIVE: MDLIVE behavioral health
Who should check with a clinician first
- Drivers, heavy machinery operators and anyone with marked daytime sleepiness, because sleep restriction can add sleepiness early on.
- People with bipolar disorder or a tendency to mania, or poorly controlled seizures, because sleep loss can worsen both.
- Anyone with signs of sleep apnea or restless legs, or who works shifts, per the VA's Insomnia Coach guidance.
Sources: American Academy of Sleep Medicine (J Clin Sleep Med, 2021): AASM 2021 behavioral treatment guideline · U.S. Department of Veterans Affairs: VA Insomnia Coach
Where to Get CBT-i (Cognitive Behavioral Therapy for Insomnia)
These are general online therapy services, not dedicated CBT-i programs. Prices were checked on October 25, 2026 where the provider's page could be opened. Confirm the current price and whether the clinician is trained in CBT-i before you book.
MDLIVE
MDLIVE lists talk therapy including CBT and accepts many major insurance plans. Its page does not mention CBT-i or insomnia specifically, so ask for a therapist trained in CBT-i.
$0 to $179 first therapy visit; $140 follow-ups before insurance
Cerebral
Offers online therapy. We could not open Cerebral's pricing page on October 25, 2026, so we removed the earlier unverified monthly figure. Ask whether the therapist delivers CBT-i.
Check the current price on cerebral.com
Brightside Health
Offers online therapy. We could not open Brightside's pricing page on October 25, 2026, so we removed the earlier unverified monthly figure. Ask whether the therapist delivers CBT-i.
Check the current price on brightside.com
How CBT-i (Cognitive Behavioral Therapy for Insomnia) Works
NHLBI describes CBT-i as a 6 to 8 week plan built from a few parts. Sleep restriction sets a fixed window for time in bed, even if you cannot sleep for all of it, and widens it as sleep improves. Stimulus control keeps the bed linked to sleep. Cognitive therapy targets worry about sleep. Relaxation or meditation and sleep education round it out, and apps such as the VA's include a sleep diary to track progress. The AASM guideline says the gains are potentially durable after treatment ends without further intervention. It also notes that sleep hygiene advice on its own is not recommended as a treatment.
Side Effects
Common
- • Daytime fatigue and sleepiness during treatment, the main harm named in the AASM guideline; it is mostly limited to the early weeks and usually resolves by the end
- • Less time in bed than you are used to at first, because sleep restriction sets a fixed window that widens as sleep improves (NHLBI)
Serious risks and warning signs
- • The AASM guideline says sleep restriction may be unsuitable for people in high-risk jobs such as drivers or heavy machinery operators, and for people with excessive daytime sleepiness
- • It may also be unsuitable for people predisposed to mania or hypomania or with poorly controlled seizures, because sleep loss can worsen both
- • The VA advises checking with a clinician first if you have sleep apnea, restless legs, bipolar disorder or epilepsy, or work shifts
Eligibility to Discuss With a Clinician
CBT-i is meant for adults with chronic insomnia. The ACP recommends it for all adults with chronic insomnia disorder as the first treatment, and suggests deciding with a clinician whether to add short-term medicine if CBT-i alone does not work. Somryst's FDA clearance covers adults 22 and older and requires a prescription; SleepioRx is cleared for adults as an add-on to usual care and also requires a prescription. Free and paid consumer apps need no prescription. If you snore loudly, stop breathing in your sleep, have restless legs, bipolar disorder or epilepsy, or work nights, see a clinician before starting a sleep-restriction program.
Related Medications
Provider Reviews
Explore providers in the sleep category. This does not mean every provider offers CBT-i (Cognitive Behavioral Therapy for Insomnia); check the exact product with the provider.
Related Articles
Frequently Asked Questions
Sources and editorial notes
Guideline recommendations come from the ACP (2016) and AASM (2021) guidelines, NHLBI and the FDA's Somryst clearance, opened on October 25, 2026. Prices come from Sleep Reset's and MDLIVE's own pages and the VA apps' App Store listings on that date; Cerebral's and Brightside's pricing pages could not be opened, so no price is shown for them. We did not enroll in any program, and no clinician review is claimed.
Content updated . Source checking is editorial work; it is not a clinical review.
- American College of Physicians (Ann Intern Med, 2016): Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of PhysiciansMedical or regulatory reference · Accessed 2026-10-25
- American Academy of Sleep Medicine (J Clin Sleep Med, 2021): Behavioral and psychological treatments for chronic insomnia disorder in adults: an AASM clinical practice guidelineMedical or regulatory reference · Accessed 2026-10-25
- National Heart, Lung, and Blood Institute (NIH): Insomnia: TreatmentMedical or regulatory reference · Accessed 2026-10-25
- FDA: 510(k) K191716: Somryst (clearance letter dated March 23, 2020, and indications for use)Medical or regulatory reference · Accessed 2026-10-25
- American Academy of Sleep Medicine: FDA clears SleepioRx for chronic insomniaMedical or regulatory reference · Accessed 2026-10-25
- Sleep Review (May 24, 2023): Nox's acquisition of Somryst a major milestoneMedical or regulatory reference · Accessed 2026-10-25
- U.S. Department of Veterans Affairs: CBT-i Coach appMedical or regulatory reference · Accessed 2026-10-25
- U.S. Department of Veterans Affairs: Insomnia Coach appMedical or regulatory reference · Accessed 2026-10-25
- Apple App Store (seller: US Department of Veterans Affairs): CBT-i CoachProvider-reported product information · Accessed 2026-10-25
- Apple App Store (seller: US Department of Veterans Affairs): Insomnia CoachProvider-reported product information · Accessed 2026-10-25
- Sleep Reset: Our PricingProvider-reported product information · Accessed 2026-10-25
- MDLIVE: Online therapy and psychiatryProvider-reported product information · Accessed 2026-10-25