Insomnia Evaluation and CBT-I Guidance
Chronic insomnia involves persistent trouble falling asleep, staying asleep or waking too early with daytime impairment despite adequate opportunity for sleep.
Evaluation comes before treatment
W8MD reviews schedule, time in bed, awakenings, naps, substances, medications, mood, pain, restless legs symptoms, breathing symptoms and behaviors that perpetuate insomnia. Sleep apnea and insomnia can coexist.
CBT-I is a first-line approach
Cognitive behavioral therapy for insomnia combines sleep scheduling, stimulus control, cognitive strategies, relaxation and sleep-hygiene education. It is more than a list of generic sleep tips and should be adapted for safety, especially when significant sleepiness, bipolar disorder, seizure risk or another condition is present.
Consistent wake time
A stable morning anchor helps regulate sleep timing.
Use the bed for sleep
Reducing prolonged wakefulness in bed can rebuild the bed-sleep association.
Review beliefs and arousal
Reducing catastrophic thinking and effortful attempts to force sleep can help.
Medication may sometimes be considered, but risks, interactions, next-day impairment and the underlying diagnosis matter.
How W8MD can help
W8MD reviews symptoms, sleep schedule, medical conditions, medications, prior testing and treatment goals, then recommends the appropriate evaluation or follow-up. Sleep and weight-management services can be coordinated when clinically relevant.
Sleep Medicine hub · Sleep apnea evaluation · Home sleep study · PAP support · Costs and insurance · Sleep apnea encyclopedia
Request a W8MD sleep evaluation
Philadelphia: 215-676-2334 · Brooklyn: 718-946-5500
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Safety notice: General education only, not diagnosis or medical advice. Evaluation and testing determine the appropriate plan. Availability, coverage, costs and results vary. Do not drive when dangerously sleepy. Call 911 for trouble breathing, chest pain, stroke symptoms or another emergency.
Content reviewed for general accuracy by W8MD clinical leadership. Last reviewed September 2026.