Cognitive Behavioral Therapy for Insomnia (CBT-I) Recommended as Primary Treatment Over Hypnotic Medications
Dr. Donn Posner, a leading expert in Cognitive Behavioral Therapy for Insomnia (CCBT-I) and president of Sleepwell Consultants, emphasizes that CBT-I is the first-line treatment for chronic insomnia. He highlights that while sleep hygiene is a component, it is insufficient as a standalone therapy for chronic cases. Posner, an adjunct clinical associate professor at Stanford University School of Medicine, explains that CBT-I focuses on addressing perpetuating factors of insomnia, such as 'sleep effort'—the mental and physical struggle to fall asleep. He notes that patients often engage in counterproductive behaviors like staying in bed when not sleeping, which CBT-I aims to correct. The therapy also tackles dysfunctional beliefs and fears associated with sleep, often requiring patients to accept that their sleep may initially worsen before improving. Posner states that the effectiveness of CBT-I is long-lasting, with studies showing maintained gains for up to 10 years, unlike hypnotic medications which ofte... 
