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. When should relaxation exercises ideally be practiced according to CBT-I guidelines? → Regularly during the day and as part of the wind-down routine
6. 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
7. What is the minimum time in bed (TIB) typically prescribed during sleep restriction therapy to protect patient safety? → 5 hours
8. Which outcome is considered the primary measure of daytime impairment in CBT-I research? → Fatigue, mood, and cognitive performance measures
9. 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
10. Which predictor most consistently predicts better CBT-I outcomes in research studies? → Greater treatment adherence
11. What is sleep hygiene? → Maintaining behaviors that support good sleep
12. Alcohol's effect on sleep architecture is best characterized as: → Reducing sleep onset latency but fragmenting sleep in the second half of the night
13. What behavioral change helps regulate circadian rhythms? → Keeping a regular sleep schedule
14. Long-term follow-up studies of CBT-I typically assess durability of outcomes at: → 6-12 months post-treatment
15. 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%
16. How should therapists handle client records? → Securely store and restrict access
17. The Insomnia Severity Index (ISI) clinical response is defined as a reduction of at least how many points? → 6 points
18. Digital CBT-I (dCBT-I) programs most commonly deliver treatment through: → Web-based or smartphone app platforms with interactive modules
19. Mindfulness-Based Therapy for Insomnia (MBT-I) combines which two approaches? → MBSR practices and standard CBT-I behavioral components
20. Which intervention helps patients with racing thoughts at bedtime? → Using cognitive refocusing techniques
21. Which of the following is NOT typically included in standard sleep hygiene recommendations? → Limiting time in bed to actual sleep time only
22. Which mindfulness principle is most relevant to reducing 'sleep effort' in insomnia? → Non-striving and letting go of outcome expectations
23. EMG biofeedback in insomnia patients typically targets which muscle group(s)? → Frontalis or trapezius muscles
24. A patient reports that trying to relax makes them more anxious. This phenomenon is known as: → Relaxation-induced anxiety
25. What is insomnia characterized by? → Difficulty sleeping and staying asleep
26. Research on CBT-I for veterans with insomnia and PTSD shows: → CBT-I improves sleep even when PTSD symptoms persist
27. Body scan meditation differs from progressive muscle relaxation in that it: → Involves passive, non-judgmental awareness without intentional muscle tension
28. The primary barrier to accessing in-person CBT-I that digital delivery addresses is: → Shortage of trained CBT-I therapists and geographic or logistical access barriers
29. What is the first step in assessing a patient for insomnia treatment? → Conducting a detailed clinical interview
30. Which sleep disorder involves breathing interruptions during sleep? → Sleep apnea