Main roads
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Insomnia is best treated with cognitive behavioral therapy, new guidelines say
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Behavioral therapy is recommended in combination with sleep medications
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The instructions recommend using sleeping pills alone
FRIDAY, April 24, 2026 (HealthDay News) — Combining medications with behavioral therapy to treat chronic insomnia may not be best for all patients, a new practice guideline says.
Cognitive behavioral therapy for insomnia (CBT-I) works best on its own, but may be combined with sleep medications for some patients, according to guidelines published in the publication. Journal of Clinical Sleep Medicine.
Researchers have found that sleeping pills on their own are less effective in treating insomnia.
“Combination therapy for insomnia is widely used in clinical practice, but evidence to guide how and when to combine treatments is surprisingly limited,” said the lead researcher. Dr. Daniel Buisseprofessor of psychiatry, medicine and clinical science and translation at the University of Pittsburgh.
“Our analysis suggests that CBT-I alone is the most effective first-line treatment for insomnia,” he said in a news release. “However, using medication with CBT-I may provide modest benefits for some specific outcomes, such as total sleep time.”
Researchers in the background notes that 10% to 15% of adults suffer from chronic insomnia.
The researchers noted that previous guidelines recommended the use of medication or behavioral therapy, but did not address the combination of the two approaches.
To develop these new recommendations, the American Academy of Sleep Medicine commissioned a panel of sleep experts to systematically review the available evidence related to the treatment of insomnia.
The results showed that cognitive-behavioral therapy was the best way to help people fall asleep.
Researchers have concluded that behavioral therapy alone produces meaningful and lasting improvements without the side effects that can be found with prescription drugs.
However, they added that behavioral therapy can also be combined with medication for some patients.
The guidelines state that the use of narcotics in sleep alone has little benefit and should be used in conjunction with behavioral therapy.
These were medications used to manage insomnia (triazolam, ramelteon, Zaleplon); sleep maintenance insomnia (doxepin, Suvorexant); and combined sleep onset and maintenance insomnia (temazepam, we were bullied, eszopiclone).
These recommendations are presented with an asterisk, but there is not much evidence behind them and more research is needed.
Instead, the guidelines recommend that people talk to their doctor about what is best for them.
“These recommendations are intended to support patient-centered, patient-centered decision-making, rather than a one-size-fits-all approach,” Buisse said.
More information
The Sleep Foundation has more to say about it insomnia.
Sources: American Academy of Sleep Medicine, news release, April 21, 2026; Journal of Clinical Sleep MedicineApril 21, 2026
What does this mean for you?
People with insomnia do best with behavioral therapy, but it can be used in conjunction with sleeping pills.
