CBT-I is a therapeutic approach designed for people who have difficulty falling and staying asleep. It’s grounded in the understanding that when a person starts to sleep poorly, they often shift their attention toward fixing the sleep problem. This can lead to an increase in anxiety about sleep as well as maladaptive behavior changes to compensate for their lack of sleep. This fixation on getting a good night of sleep - and the resulting behavior changes - often backfire, causing the sleep problem to worsen (i.e. go from acute to chronic).

CBT-I targets these behaviors and the accompanying stress around sleep using four methods: stimulus control, sleep restriction, cognitive therapy, and sleep hygiene. During therapy, we will work together to identify what might be causing your issues with sleep and we’ll develop concrete strategies to help you “un-learn” bad sleep habits and gradually train your body to naturally shift toward better, more restorative sleep.

If you have trouble falling or staying asleep and you feel tired during the day, then CBT-I may be a good fit for you. Insomnia does not tend to go away on its own, and it can have far-reaching impacts on health and wellbeing if left unmanaged. You do not need to have an insomnia diagnosis to try CBT-I. During your first appointment, I’ll ask questions to get to know you and your specific situation. We will determine together whether we think you will be a good match for CBT-I treatment.

If you aren’t sure whether CBT-I is a good fit for you, I am happy to discuss this with you during a consultation. Generally speaking, however, it’s not a great idea to start CBT-I at a time when it may be difficult to maintain a consistent sleep schedule in the upcoming 8 weeks, or if you have an important event coming up that will require you to be fully rested. For example, if you are a new parent, if you will be traveling out of the country, or if you have a big work presentation coming up, you may want to postpone CBT-I for another time.

There is strong evidence to support CBT-I as an excellent first-line treatment for people who have chronic sleep problems in addition to certain other physical and psychiatric conditions such as depression, anxiety, and chronic pain. However, it is not recommended for people with unmanaged bipolar disorder or seizure disorder. Additionally, if you have sleep apnea and you haven’t sought treatment for this yet, I will likely recommend that you reach out to your primary care physician to address this first.

Yes. The research overwhelmingly confirms that CBT-I works, and it is backed by professional organizations such as the National Institutes of Health (NIH), the American Academy of Sleep Medicine (AASM), and the American College of Physicians (ACP). Sleep research shows that CBT-I is as effective as sleep medications. However, CBT-I has a better efficacy long-term, with results that last long after treatment is over - all without the negative side effects that come with medications. That being said, CBT-I doesn’t work for everyone, and I can’t guarantee that it will work for you. However, if you haven’t tried it, it may be worth looking into whether it’s the right next step for you.

Typically CBT-I produces durable results in 8 weeks. You should expect it to take approximately 8 weekly sessions, though this will depend on your level of participation in the treatment, as well as your unique situation. As therapy progresses, we will reassess the need to reduce or add sessions.

Each session is $180 out-of-pocket.

I'm not in-network with any insurance companies. Some insurance companies have out-of-network benefits that allow you to get reimbursed for part of the session cost. Please let me know if you would like to submit claims to your insurance company, and I'll provide you with a superbill after each session to use for this.

I only offer Telehealth through a HIPAA-approved software called SimplePractice. While there are pros and cons to both in-person and online therapy sessions, current research suggests that Telehealth CBT-I is just as effective as in-person CBT-I. Though I see clients online, I am only able to provide therapy to residents of Washington, DC.

If you are already taking a medication to help you sleep, you can still participate in CBT-I. However, sleep medications should not be prescribed immediately before starting CBT-I treatment, as it will be difficult to tease out what is influencing any changes in sleep you may experience. As a part of your clinical intake, I will ask you what medications you are taking, and we will discuss together whether you would like to stay on them or taper off. If you are interested in discontinuing your prescribed sleep medication(s), I will ask you to discuss this with your prescribing physician, or I can consult with your physician directly (with your permission).

You do not need to get a sleep study (also called a polysomnogram or PSG) in order to participate in CBT-I. If you’ve already done one, however, please let me know! PSGs provide a wealth of valuable data that can help us accurately address your sleep concerns. PSGs can also be used to diagnose sleep apnea and other sleep disorders. If it seems likely that you have an undiagnosed sleep disorder, I may recommend that you get a PSG prior to starting CBT-I.