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Why CBT-I is the place to start
Cognitive behavioural therapy for insomnia (CBT-I) is the first-line approach for long-term insomnia in UK and international guidance, including NICE's insomnia summary and the AASM guideline. In the UK there are several ways to get it free. They are worth trying before you pay for anything.
What you can get depends on where you live. The routes below are a good order to check them in.
Route 1: an NHS-funded digital programme
In 2022, NICE published guidance on Sleepio, a digital CBT-I programme, as an option for people with insomnia in primary care. It is free to adults across Scotland. In England it is funded in some areas, so ask your GP whether it is available locally.
Sleepstation is another digital CBT-I service with NHS funding in some areas. Its website has an NHS options page where you can check what applies to you.
Digital programmes tend to have the shortest waits, and you can usually start from home.
Route 2: ask your GP
Your GP can tell you what is commissioned in your area. Before the appointment, keep a sleep diary for one to two weeks. It gives the GP a clear picture and makes the conversation quicker.
Useful things to say:
- how long the sleep problem has gone on, and how many nights a week
- how it affects your days, work and mood
- what you have already tried
- that you would like to try CBT for insomnia rather than sleeping tablets, if that is your preference
Your GP may also want to check for other causes first, such as sleep apnoea, restless legs, pain or low mood. Our free self-check can help you note down any signs to mention.
Route 3: NHS Talking Therapies
In England, you can refer yourself to NHS Talking Therapies without seeing a GP. Many services offer help with sleep, especially when it comes alongside stress, anxiety or low mood. Some run sleep groups or guided self-help using CBT-I techniques.
Ask when you refer whether they offer insomnia support. Waits and options vary from service to service.
Route 4: a hospital insomnia service
A few NHS hospitals run specialist insomnia clinics, such as the UCLH insomnia service in London. These usually need a GP referral and are aimed at more complex or long-standing cases. Waiting lists can be long.
Face-to-face CBT-I with a trained therapist is not available everywhere on the NHS. That is one reason digital programmes have become a common first route.
If nothing is available near you
Sometimes the free routes are not open where you live, the wait is long, or you would rather start now. Other options then include self-help books based on CBT-I, free apps, and paid online courses. Self-guided courses, ours among them, are one of those options.
Whichever you choose, look for a sleep diary, a sleep window with a safety check, and help with getting up when wide awake. Some people should talk to a clinician before using a sleep window, including anyone pregnant or with bipolar disorder, epilepsy or suspected sleep apnoea. If you are unsure where you stand, start with the self-check and a chat with your GP.
FAQ
- Can I get CBT-I free on the NHS?
- Often, yes. Depending on where you live, routes include an NHS-funded digital programme, NHS Talking Therapies, or a referral to a hospital sleep service. What is offered varies by area.
- Can I refer myself for CBT-I?
- In England you can refer yourself to NHS Talking Therapies, and some services offer help with sleep. Some digital programmes also let you check NHS availability by postcode.
- How long is the wait for an NHS insomnia service?
- It varies a lot. Digital programmes can often start within days. Specialist hospital sleep services usually need a GP referral and can have long waiting lists.