CBT-I Cheat Sheet 2026

The 30 highest-yield CBT-I facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which organizations have endorsed CBT-I as the first-line treatment for chronic insomnia in adults? → American Academy of Sleep Medicine (AASM) and American College of Physicians (ACP)
2. The typical response rate for CBT-I in randomized controlled trials is approximately: → 70-80%
3. Research on fully automated dCBT-I without therapist involvement shows: → Significant improvements in insomnia severity, often comparable to therapist-guided CBT-I
4. What is confidentiality in professional practice? → Protecting client information unless legally required
5. A sleep diary reveals a patient's sleep onset latency (SOL) averages 65 minutes across two weeks. Which CBT-I component most directly targets this finding? → Stimulus control therapy
6. When should relaxation exercises ideally be practiced according to CBT-I guidelines? → Regularly during the day and as part of the wind-down routine
7. What information from a patient interview would most support a diagnosis of psychophysiological insomnia rather than another insomnia subtype? → Sleeping better away from home and heightened arousal at bedtime in the home environment
8. When obtaining informed consent for CBT-I, which element is most critical to include? → The temporary worsening of sleepiness that may occur during sleep restriction
9. In CBT-I, understanding that insomnia is perpetuated by behaviors like excessive time in bed is based on which physiological principle? → Diluted homeostatic sleep drive
10. When establishing the initial prescribed sleep window in sleep restriction therapy, what is generally the minimum recommended time in bed (TIB)? → 5 hours, to avoid excessive sleep deprivation risk
11. What is the minimum time in bed (TIB) typically prescribed during sleep restriction therapy to protect patient safety? → 5 hours
12. Which outcome is considered the primary measure of daytime impairment in CBT-I research? → Fatigue, mood, and cognitive performance measures
13. When treating insomnia in cancer patients, which unique factor must be incorporated into the CBT-I case conceptualization? → Treatment-related symptoms such as pain, nausea, and hot flashes that disrupt sleep
14. Which sleep diary variable is used as the primary metric when making week-to-week adjustments in sleep restriction therapy? → Sleep efficiency (SE) averaged over the preceding week
15. Which predictor most consistently predicts better CBT-I outcomes in research studies? → Greater treatment adherence
16. What is sleep hygiene? → Maintaining behaviors that support good sleep
17. Alcohol's effect on sleep architecture is best characterized as: → Reducing sleep onset latency but fragmenting sleep in the second half of the night
18. What behavioral change helps regulate circadian rhythms? → Keeping a regular sleep schedule
19. Long-term follow-up studies of CBT-I typically assess durability of outcomes at: → 6-12 months post-treatment
20. A patient's sleep diary shows an average total sleep time of 5.5 hours and an average time in bed of 8 hours. What is their sleep efficiency? → 69%
21. How should therapists handle client records? → Securely store and restrict access
22. The Insomnia Severity Index (ISI) clinical response is defined as a reduction of at least how many points? → 6 points
23. Digital CBT-I (dCBT-I) programs most commonly deliver treatment through: → Web-based or smartphone app platforms with interactive modules
24. Mindfulness-Based Therapy for Insomnia (MBT-I) combines which two approaches? → MBSR practices and standard CBT-I behavioral components
25. When delivering psychoeducation about sleep homeostasis in CBT-I, which analogy best explains sleep drive? → Hunger that builds throughout the day and is satisfied by eating (sleeping)
26. Which intervention helps patients with racing thoughts at bedtime? → Using cognitive refocusing techniques
27. Which of the following is NOT typically included in standard sleep hygiene recommendations? → Limiting time in bed to actual sleep time only
28. Which mindfulness principle is most relevant to reducing 'sleep effort' in insomnia? → Non-striving and letting go of outcome expectations
29. Which of the following best explains why core body temperature drops at sleep onset? → Peripheral vasodilation redistributes heat away from the core
30. When titrating sleep restriction, what minimum sleep window is typically maintained to prevent excessive daytime impairment? → 5 hours