What Is Sleep Therapy? How to Overcome Insomnia Without Medication
Sleep therapy probably isn’t the first thing you considered when you started struggling with insomnia. You might have already tried sleep hygiene advice, products, medication or hacks, yet are still having trouble sleeping and are considering getting some personalised support from a specialist. And this is where sleep therapy comes in.
Whether you’ve recently started struggling to sleep or have had insomnia for years, sleep therapy can help you - read on to find out how!
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Disclaimer: Please remember that this blog post is for educational purposes only and is not a substitute for therapy or medical advice. If you feel you need more help I encourage you to seek professional support or contact your GP.
What Is a Sleep Therapist?
Simply put, a sleep therapist is a professional, such as a psychologist, therapist or psychotherapist, who has completed further training in working with sleep or insomnia. They are trained in effective therapeutic approaches or behavioural sleep medicine, which enables them to offer structured support and sleep guidance.
Sleep therapy usually isn’t the first thing people consider when they are having trouble sleeping - in fact, you might not even have known that sleep therapy existed!
So you might be surprised to learn that Cognitive Behavioural Therapy for Insomnia (CBT-I) is the first-line recommended treatment for chronic insomnia in adults (NICE, 2025). Acceptance and Commitment Therapy for Insomnia is another increasingly popular approach that I use in my practice which has also been shown to be effective in studies (Saldaña et al., 2023, Hämäläinen et al., 2025).
Sleep therapists are trained to go beyond sleep hygiene advice, quick fixes and products, providing evidence-based, actionable support that gets to the root of your trouble sleeping.
As a sleep therapist, the key ways I support my clients include:
Sharing sleep science
Working together to identify and address the factors keeping insomnia going
Using effective, psychological and behavioural strategies to retrain a healthy sleep pattern
Although it might be hard to believe right now, your body knows how to sleep. Sleep therapists help you to support your body’s natural sleep processes, so that you can get your sleep back on track and start sleeping naturally again.
Who Is Sleep Therapy For?
Sleep therapy can help with a variety of sleep problems and is commonly recommended for insomnia.
Some sleep therapists may provide specialised support for other sleep disorders too, such as parasomnias or nightmares.
But what exactly is insomnia?
Insomnia involves difficulty falling asleep, staying asleep or waking too early and being unable to get back to sleep. You don’t have to experience all three to have it. This non-restorative sleep also leads to impaired daytime functioning, such as fatigue, irritability or difficulty concentrating.
Insomnia can be diagnosed by a qualified professional, such as your GP, but you don’t have to have a diagnosis to seek support.
Sleep therapists aren’t usually medically trained, so aren’t qualified to diagnose insomnia or treat it with medication, but they can help you to implement effective strategies to improve your sleep.
Some of the most common reasons people reach out to me about starting sleep therapy include:
Frequently lying awake for hours, desperately trying to fall asleep, watching the clock and worrying about how they’ll cope tomorrow
Waking at 3am with a racing mind, unable to get back to sleep, their mind filled with “what if’s…?” and thoughts of all the things on their to-do list
Feeling tired, on edge and struggling to focus during the day
Anxiety or stress is impacting their ability to get a good night’s sleep
Going to bed feeling “tired but wired”
They’ve tried improving their sleep hygiene, taking supplements, using sleeping pills, herbal teas & more, but nothing seems to work
This might have been going on for a few months, years or even decades.
If any of the above resonates, you are likely to find insomnia therapy helpful.
How Sleep Therapy Can Help You Overcome Insomnia
Whether you used to sleep well or have had insomnia for years, you may be wondering why you are still struggling to sleep. You might be having thoughts like, “Will I ever sleep normally again?” or “Is this just my life now?”.
Despite researching self-help advice and improving your sleep hygiene, nothing seems to result in a consistent improvement. You probably feel like you’ve tried everything, from magnesium supplements to meditation apps, and herbal teas to weighted blankets. Although these sleep aids may help you optimise good sleep, they are very unlikely to resolve chronic insomnia.
Once you’ve improved your sleep hygiene, you may feel that there’s nothing else you can do to improve your trouble sleeping, leaving you feeling hopeless and out of control.
You might believe your poor sleep is down to genetics or a chemical imbalance that you can’t do anything about.
But the reality is that insomnia is a multi-dimensional issue and you do have more control than you think.
To understand how sleep therapy can help, let’s look at the three key factors that contribute to the development & maintenance of chronic insomnia.
The Key Factors Contributing To Insomnia
There are three key factors involved in the development and maintenance of insomnia, based on the 3Ps model of insomnia.
1 - Predisposing Factors
These are underlying risk factors for insomnia, such as genetics, family history, or anxiety.
Predisposing factors tend to be out of our control or difficult to change. These factors alone do not cause chronic insomnia or poor sleep.
2 - Triggers
There are many different events or situations that can trigger the onset of insomnia.
For example, losing a job, moving house, illness, noise, work stress, menopause, pregnancy, a breakup or travel. It might be one stressor or an accumulation of things and they may be out of your control.
These factors can “push” someone over the threshold into experiencing acute insomnia.
3 - Maintaining Factors
Maintaining factors keep insomnia going long-term, even if the initial trigger has resolved. These are the factors that you can do something about.
When trying to fix insomnia, it is often the initial trigger that people focus on. But when it comes to addressing insomnia, identifying and addressing the maintaining factors is key. This can be challenging to do alone and is where the expertise of a sleep therapist becomes really helpful.
What Does Insomnia Therapy Involve?
Insomnia therapy is a short-term, structured therapy, which is usually effective within a few weeks to months.
Sleep therapy can be delivered in-person or online and different therapists or coaches vary in the approach they use, so it is important to take this into consideration when searching for a therapist.
In my insomnia clinic, we start therapy by exploring your unique situation, spending the first session discussing what brings you to therapy. This helps me to tailor the following sessions to be most beneficial for you. Some of the things we might talk about in your first session include:
Your current sleep challenges
Your sleep history
The impact of anxiety or stress on your sleep
Any health conditions, pain or medications that could be impacting your sleep
How sleep is affecting your life
What you’ve already tried and things that make it better or worse
Your habits and routines
I also encourage my clients to set goals for therapy, which helps us to measure progress and ensure you are getting the most out of working together.
Subsequent sessions involve learning skills, strategies and knowledge to help you work towards your goals and improve your sleep. In my therapy sessions, this might look like:
Exploring beliefs and expectations around sleep
Learning how sleep actually works
Changing unhelpful behaviours and creating helpful sleep habits
Cognitive strategies, such as learning how to respond to anxious thoughts differently, so they interfere less with your sleep
Behavioural strategies to retrain a healthy sleep pattern
Rebuilding a positive connection between the bed and sleep, so you go to bed feeling relaxed & sleepy, rather than alert & anxious
Managing related anxiety and stress
Strengthening your sleep drive or ‘appetite’, so you sleep for longer & more deeply
Practising relaxation or mindfulness skills and learning how to use them in a way that supports sleep
A key aspect of sleep therapy is between-session tasks, which help you to consolidate what you’ve learned and rebuild a healthy sleep pattern.
What Are the Most Effective Therapeutic Approaches for Insomnia?
Cognitive Behavioural Therapy for Insomnia is commonly recommended as the gold standard, first-line treatment for insomnia, with multiple research studies indicating its effectiveness.
Another approach that is increasingly being used, alongside or as an alternative to CBT-I, is Acceptance and Commitment Therapy (ACT-I), which has been shown to be effective in emerging research.
Let’s take a look at these in more detail and explore how they can help you…
What Is Cognitive Behavioural Therapy for Insomnia (CBT-I)?
CBT-I has been extensively researched and shown to be up to 80% effective in treating insomnia.
As the name suggests, CBT-I involves multiple components, including cognitive (thought) and behavioural interventions for insomnia, as well as sleep education. It helps address the unhelpful thinking and behaviour habits you may have unintentionally developed, that are maintaining your trouble sleeping.
CBT-I is somewhat similar to CBT but involves far more tailored strategies specifically for insomnia. So, if you have tried general CBT for anxiety or depression but not found it helpful, don’t be put off trying CBT-I!
It should also be noted that CBT-I is not just “sleep restriction” and goes beyond sleep hygiene which, while important, will not resolve insomnia alone.
What Is Acceptance and Commitment Therapy for Insomnia (ACT-I)?
ACT focuses on changing the relationship you have with wakefulness or your thoughts. It increases your ability to tolerate and navigate challenges, but without proper explanation the concept can be misunderstood.
You might wonder why you would possibly want to work on acceptance. If you’re struggling to sleep, the last thing you want to do is accept it – that’s why you’re seeking support after all!
I think acceptance is often confused with resignation. Acceptance does not mean giving up and staying stuck. Instead, it’s about acknowledging the situation and being able to tolerate, or sit with the discomfort you’ve been trying to avoid.
When you struggle with insomnia, it’s easy to get caught up in overthinking, resisting unpleasant feelings and trying to control sleep.
But paradoxically, when we let go of trying to force sleep, that’s when we create the conditions for sleep to occur naturally.
As a therapist, I share a variety of tools and techniques to help you build the skill of acceptance. When you understand and implement this concept consistently it really is a game-changer!
The other key aspect of ACT is taking aligned action with your values, despite the difficulties you are currently experiencing. Poor sleep can leave you feeling exhausted, irritable and frustrated. You may find yourself cancelling plans and withdrawing from things that previously bought you joy.
All your energy goes towards trying to fix your sleep and avoid further discomfort. But the problem with this is insomnia can start to consume your life.
While avoidance may bring short-term relief, in the long-term it negatively impacts your mood and keeps you stuck in a vicious cycle of poor sleep.
In therapy, we may explore how you can continue to take action towards the things that give you meaning, even if that involves being more flexible or modifying your usual activities.
What are the benefits of therapy for insomnia?
There are so many benefits of insomnia therapy and I think it’s easy to underestimate the value of working with someone who really understands sleep and can provide tailored support for your situation.
Struggling with insomnia can bring up all sorts of emotions, from anxiety, to frustration and loneliness, and having someone to listen to your challenges and compassionately support you to overcome insomnia can be life-changing.
As a sleep therapist, I aim to empower you with the knowledge and skills to support your sleep for life. This is invaluable and means that benefits persist long beyond the end of therapy, unlike sleep medication.
As I mentioned earlier, when I work with clients it is so important to me that we identify and address the factors keeping insomnia going, allowing you to make sustainable improvements to your sleep. This is something to look out for when choosing a sleep therapist, as once insomnia becomes chronic it needs to be dealt with as a problem in it’s own right - only dealing with the initial cause is unlikely to be effective.
That’s not to say that we ignore the original cause of the issue, as addressing it can be an important part of the puzzle and can prevent insomnia recurring in the future. But addressing the combination of factors maintaining insomnia, such as sleep anxiety or unhelpful behaviours, is key to better sleep in the long-term.
Another benefit of working one-to-one with a sleep therapist is that support can be personalised. Sleep therapy can be challenging sometimes, so having someone you are accountable to and can ask questions to is also really helpful.
Finally, I invite you to think about the impact overcoming insomnia would have on your life. This will look slightly different for everyone but might look like:
Feeling more present with your partner or children, instead of distracted and irritable
Able to focus on fulfilling your career goals or building a business having had a good night's sleep
Having the energy to take up an old hobby, get back into fitness or go travelling
Being able to relax and enjoy your evenings again, rather than worrying about sleep
Whether you’ve struggled with insomnia for months or years, it is possible to improve your sleep and sleep therapy might just help you to do so.
Further Support
I’d love to know if you found this post helpful. Do feel free to pop me a message if you have any feedback. You can find me on Instagram @therapywithamy_ , where I share more tips and insights about sleep.
To find out more about 1:1 support for poor sleep, insomnia and general anxiety, click the links below:
References
Hämäläinen, T., Lappalainen, P., Langrial, S. U., Lappalainen, R., & Kiuru, N. (2025). Mechanisms of change in an online acceptance and commitment therapy intervention for insomnia. Scientific reports, 15(1), 2868. https://doi.org/10.1038/s41598-025-87018-3
Muench A., Vargas I., Grandner M.A., Ellis J.G., Posner D., Bastien C.H., Drummond S.P., Perlis M.L. (2022) We know CBT-I works, now what? Faculty Reviews, 11(4). PMID: 35156100; PMCID: PMC8808745.
National Institute for Health and Care Excellence: Insomnia Guidelines https://cks.nice.org.uk/topics/insomnia/
Rossman, J. (2019) Cognitive-Behavioral Therapy for Insomnia: An Effective and Underutilized Treatment for Insomnia. American Journal of Lifestyle Medicine. 13(6), 544-547. doi: 10.1177/1559827619867677
Saldaña, K. S., McGowan, S. K., & Martin, J. L. (2023). Acceptance and Commitment Therapy as an Adjunct or Alternative Treatment to Cognitive Behavioral Therapy for Insomnia. Sleep medicine clinics, 18(1), 73–83. https://doi.org/10.1016/j.jsmc.2022.09.003
Wright et al. (2019) A Framework for Understanding the Role of Psychological Processes in Diseases Development, Maintenance, and Treatment: The 3P-Disease Model.
van Straten et al. (2018) Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis.