Cognitive Behavioural Therapy for Insomnia (CBT-I) in BC

Sleep can be relearned. Online CBT-I is available across British Columbia in English and Portuguese.

When the night feels longer than the day

You go to bed exhausted, and the moment your head touches the pillow, your mind switches on. Or you fall asleep fine, then wake at 3 a.m. and watch the clock until morning. You have tried the tea, the apps, the earlier bedtime. Maybe you have tried sleeping pills too.

If this has been going on for weeks or months, you are not doing anything wrong. Insomnia often starts with stress, a move, a new baby, grief or a health change, and then keeps going on its own. The good news is that the habits and worries keeping it alive can be changed.

What is CBT-I?

Cognitive Behavioural Therapy for Insomnia (CBT-I) is a short, structured therapy that helps your body and mind relearn how to sleep. It is the recommended first-line treatment for chronic insomnia in adults, ahead of sleep medication, in clinical guidelines from North America and Europe.

CBT-I is not the same as "sleep hygiene". Tips like cutting caffeine can support general sleep health, but they are rarely enough on their own to reverse chronic insomnia. CBT-I works on the patterns that keep insomnia going: an irregular sleep schedule, a bed that has become linked with being awake, and worry about sleep itself.

What to expect

CBT-I usually runs 4 to 8 weekly sessions of 50 minutes, by secure video from anywhere in BC. Your first session is an assessment of your sleep, health, routines and goals. Between sessions, you'll keep your sleep diary and practise one or two changes at a time.

The first couple of weeks can feel harder before they feel better, especially with sleep scheduling. That is expected, and we adjust the plan with you each week. Many people notice clear changes within a few weeks.

Sleep and the rest of your life

Insomnia rarely exists on its own. It often travels with anxiety, low mood, trauma, chronic pain, ADHD, parenting stress or the upheaval of moving to a new country. At Psychotherapy Room, our approach is trauma-informed and culturally responsive. If nightmares or past trauma are part of the picture, we can pair sleep work with trauma therapy such as EMDR.

Start sleeping better

You don't have to keep pushing through the nights alone. Book a free 15-minute consultation to see if CBT-I is a good fit for you.

CBT-I em português

Você tem dificuldade para dormir ou acorda no meio da noite e não consegue voltar a dormir? Oferecemos TCC-I (Terapia Cognitivo-Comportamental para Insônia) online em português, para quem vive em qualquer lugar da Colúmbia Britânica. Agende uma consulta gratuita de 15 minutos.

Fees and coverage

Individual sessions are $150–$190. We bill most extended health plans directly, so check whether your plan covers Registered Clinical Counsellors. Lower-cost sessions with supervised master's-level counselling interns may also be available.

Signs you might benefit from CBT-I

• It takes you more than 30 minutes to fall asleep most nights

• You wake during the night and struggle to get back to sleep

• You wake too early and can't fall back asleep

• You feel tired, foggy or irritable during the day

• You worry about sleep during the day, or dread going to bed

• You lie in bed with racing thoughts, replaying the day or planning tomorrow

• You rely on sleep aids, alcohol or cannabis to fall asleep, and want another option

• Your sleep problems have lasted three months or more, at least three nights a week

How CBT-I works

Together, we build a plan around your life, your schedule and your goals. Most CBT-I programs include:

• A sleep diary: a simple daily log that shows what is really happening with your sleep, so we can track change week by week

• Sleep scheduling: a steady wake-up time and a personalised window for sleep that builds your natural sleep drive

• Stimulus control: steps that retrain your brain to link your bed with sleep, not with tossing and turning

• Calming the racing mind: tools to work with night-time worry and unhelpful beliefs about sleep

• Relaxation skills: breathing, body-based and mindfulness practices to help you wind down

• Relapse prevention: a plan for the rough nights that still happen, so one bad night doesn't become a bad month

Is CBT-I right for me?

CBT-I is designed for adults with ongoing insomnia. In your first session, we'll ask about other things that can affect sleep, such as snoring or pauses in breathing, restless legs, shift work, mood changes and medications. If something else may be going on, we'll suggest checking in with your family doctor or a sleep clinic, and we can work alongside them.

Some parts of CBT-I, like sleep scheduling, are adapted or used with care for people with bipolar disorder, seizure disorders, untreated sleep apnea, or jobs where drowsiness is a safety risk. Please tell us if any of these apply to you.

If you take sleep medication, you don't need to stop before starting CBT-I. Please don't change your medication without talking to your prescriber. Our clinicians are Registered Clinical Counsellors (RCC) with the BC Association of Clinical Counsellors and do not prescribe or adjust medication.

CBT-I at Psychotherapy Room is offered by Katrina Onysko, RCC