Where to get CBT-I for free

When poor sleep has gone on for months, doctors' guidelines recommend CBT-I, cognitive behavioral therapy for insomnia, before anything else. A therapist usually takes you through it in four to eight sessions. Therapists who do it are scarce in a lot of places, and not all of them take insurance. If you're doing it on your own, start with Insomnia Coach, a free app from the VA, or Sleepio if you live in Scotland.

Insomnia Coach and SleepEZ, from the VA

Insomnia Coach is a free app from the US Department of Veterans Affairs, for iPhone and Android, and you don't have to be a veteran to use it. It takes you through five weeks of CBT-I, with a sleep diary and feedback on your sleep. You can use it on its own or while you're seeing a doctor or therapist. Search for "Insomnia Coach VA" so you get the right one.

If you'd rather use a computer, the VA's free Path to Better Sleep site has SleepEZ, a six-week CBT-I course you can take with no sign-up, and a five-minute Sleep Check-up for other sleep problems.

Before you start either, the VA suggests checking with a doctor if you have sleep apnea or restless legs, bipolar disorder, epilepsy, sleepwalking or night terrors, a lot of daytime sleepiness, or a risk of falling if you get up in the night. It says they may not suit shift workers or anyone whose job keeps them up at night.

The VA's other app, CBT-i Coach, is built for people working through CBT-I with a clinician, and the VA says it isn't for use on your own.

Sleepio on the NHS

Sleepio is a six-week online CBT-I course. It's free to everyone 18 and over in Scotland through the NHS, and you can sign yourself up without seeing your GP first. In England, NICE recommended it in 2022, so GPs can offer it, but not every area does. Ask at your practice.

A therapist, if you'd like one

If you'd rather work with a person, the International Directory of CBT-I Providers and the Society of Behavioral Sleep Medicine both list trained clinicians, and many see people by video in the states where they're licensed. This route usually isn't free, and in 2016 four US states had no behavioral sleep providers at all. In the US, check what your insurance covers. In the UK, your GP can tell you what's offered locally.

Books from the library

There are good self-help books on CBT-I. These are worth borrowing:

• Say Good Night to Insomnia by Gregg Jacobs, a six-week program.
• Quiet Your Mind and Get to Sleep by Colleen Carney and Rachel Manber, for insomnia that comes with anxiety, low mood or chronic pain.
• Overcoming Insomnia by Colin Espie, a step-by-step guide from the UK.

If you take a sleep medicine, talk to your doctor before you change or stop it, whatever a book or app suggests.

Sleep restriction

Most CBT-I programs include sleep restriction. For a few weeks you spend only about as long in bed as you're actually sleeping, so sleep pressure builds and sleep gets less broken, then time is added back as it settles. It's one of the parts of CBT-I that does the most work, and it can leave you very drowsy in the day at first.

Do it through a structured program like the ones above, or with a clinician, rather than making up your own. Don't drive if you're drowsy. Check with a doctor first, and do it with their help, if you have sleep apnea or another sleep disorder, bipolar disorder, psychosis or epilepsy, if you're pregnant, already very sleepy in the day or at risk of falls, or if sleepiness would be dangerous in your job.

Where Goodmorrow fits

Goodmorrow isn't a CBT-I program. We pick one habit at a time, from the nights your ring or watch has tracked or from a few questions, and coach you through it with a nudge and a morning check-in. Some of the habits come from CBT-I and some are sleep basics, and we left sleep restriction out. It's free too, and it suits people who know what to do but find it hard to keep up. For the full program, go with one of the options above. If a program has given you set times for bed and getting up, go by its times.