Insomnia therapy onlineSleep calmly and naturally again.

The NHS describes insomnia as regularly having problems sleeping, which can include finding it hard to go to sleep, waking up several times during the night, lying awake at night, waking early and not being able to get back to sleep, still feeling tired after waking, and difficulty napping despite tiredness¹. During the day, it can cause tiredness, irritability and difficulty concentrating.

Short spells of poor sleep are normal during stressful periods. Insomnia becomes chronic when it happens on most nights for several months, and at that point the original trigger often matters less than the habits and worries that have grown around sleep.

Insomnia is often maintained by understandable attempts to fix it:

• Spending longer in bed to catch up, which makes sleep lighter and more broken.
• Irregular schedules, especially lie-ins and naps after a bad night.
• Trying hard to sleep, which raises arousal.
• Using the bed for worrying, scrolling or working, so the brain associates bed with being awake.
• Worry about sleep itself: "If I don't sleep, tomorrow will be a disaster."
• Clock-watching, which fuels frustration and calculation.
• Alcohol as a sleep aid, which disrupts the second half of the night.

The American Academy of Sleep Medicine's clinical practice guideline on behavioural and psychological treatments recommends multicomponent cognitive behavioural therapy for insomnia for adults with chronic insomnia². A meta-analysis of 87 randomised controlled trials, comparing 118 treatments with untreated controls, found significant improvements in insomnia severity, sleep efficiency, sleep quality, time awake after sleep onset and time taken to fall asleep; face-to-face treatments of at least four sessions appeared more effective than self-help or shorter formats³. The NHS also notes that cognitive behavioural therapy may be offered for insomnia¹.

Our therapists work in an integrative, evidence-informed way and use CBT-I techniques where helpful. Sessions usually include:

• A sleep diary, to understand your actual pattern rather than relying on memory.
• Stimulus control: going to bed only when sleepy and getting up if you cannot sleep, so the bed becomes linked with sleep again.
• Sleep scheduling: a regular wake-up time and, where appropriate, a temporarily shortened time in bed that is gradually extended as sleep consolidates.
• Working with worry: techniques for the racing mind, such as setting aside "worry time" earlier in the evening and questioning catastrophic thoughts about sleep.
• Relaxation skills to lower physical arousal.
• Sleep-friendly habits around light, caffeine, alcohol, exercise and screens, tailored to your life rather than imposed as rigid rules.
• Addressing what lies underneath: stress, low mood, anxiety or life changes that are disturbing sleep.

Changes are planned together, and sleep may feel worse for a short time in the early stages of sleep scheduling before it improves, which is why ongoing support helps.

Insomnia work suits video sessions well: it is structured, uses diaries and practical plans, and is easy to fit around work. Research comparing video therapy with in-person therapy has found broadly similar outcomes across common problems⁴, and telemedicine treatment has been found broadly equivalent to in-person care for mood and anxiety disorders that often accompany insomnia⁵.

Consider therapy if poor sleep has lasted more than a few weeks, is affecting your mood, concentration or work, or if you rely on alcohol or sleeping tablets to get through the night. Seek medical advice promptly for the warning signs listed above. If sleeplessness comes with thoughts that life is not worth living, seek help urgently; see below.