Licensed healthcare professionals who deliver cognitive behavioral therapy for insomnia take this exam to earn the CBTI-C credential from the Board of Behavioral Sleep Medicine. This page lists the verified exam facts: 120 scored items in 2.5 hours, a U.S. $445 fee, and renewal every 5 years. It also links our free practice sets by topic and works through sample questions with full explanations.

CBT-I Exam at a Glance

What the CBT-I is and how it works

According to Board of Behavioral Sleep Medicine, “The CBTI-C Examination is a computer-based examination composed of 120 scored items with a total testing time of 2.5 hours.”^[1]

The CBTI-C credential from the Board of Behavioral Sleep Medicine (BBSM) is for clinicians who provide cognitive behavioral therapy for insomnia. You take the exam on a computer at a Prometric test center. It has 120 scored multiple-choice items and a total testing time of 2.5 hours. The application and examination fee is U.S. $445.

Eligibility. You need a bachelor's degree and a healthcare license. You also need either SBSM-accredited training or the Alternate Track, which requires a total of 100 hours of equivalent training and clinical experience. The BBSM candidate guide says which licenses qualify and how to document your hours, so check your own background against it before you apply.

Scoring. The passing score is an absolute standard set with the modified Angoff technique. The facts we verified do not include a specific cut score, so focus on understanding the material rather than chasing a target number. Results are released within approximately 4 weeks of the close of the testing period.

Retakes and renewal. You can take the exam as often as you want by filing a new application and paying the re-examination fee. The credential is valid for 5 years. To renew, complete at least 40 hours of continuing education, or retake and pass the current exam.

Policies can change, so confirm every detail in the official BBSM CBTI-C candidate guide at bsmcredential.org.

Worked examples: how to reason through CBT-I questions

These are practice questions written for this site, not questions from the real exam. Each explanation shows why the right answer is right and why the others are wrong.

Example 1

Question: A CBT-I practitioner discovers that a client is also receiving sleep coaching from an unlicensed online service. What is the most ethically appropriate first step?

1. Immediately terminate the therapeutic relationship
2. Discuss the concurrent services openly with the client and assess potential conflicts
3. Report the unlicensed coach to licensing authorities
4. Continue treatment without addressing the issue

Answer: B. Discuss the concurrent services openly with the client and assess potential conflicts

Explanation:

B is correct. When a client is getting sleep advice from somewhere else, your first job is to understand it. Talking about it openly shows you what the coach recommends, whether it conflicts with your treatment plan, and what the client wants, while keeping the client's welfare and autonomy at the center. A is wrong because ending care abruptly abandons the client over an issue you have not yet assessed. C is premature: a report may or may not be justified, you cannot judge that before you know the facts, and the client's confidentiality also matters. D is wrong because conflicting advice left unaddressed can undermine treatment, for example if the coach contradicts sleep restriction instructions. Rule to remember: in ethics questions, the best first step is usually to gather information by talking openly with the client before escalating or withdrawing.

Example 2

Question: What role does education play in CBT-I?

1. Provides complex scientific data only.
2. Increases understanding and compliance
3. Discourages patient participation.
4. Reduces therapy effectiveness.

Answer: B. Increases understanding and compliance

Explanation:

B is correct. Psychoeducation explains how sleep is regulated, why insomnia persists, and the reasoning behind techniques such as stimulus control and sleep restriction. Clients who understand why a demanding instruction exists are more likely to follow it, and that is what makes the behavioral components work. A is wrong because education in CBT-I should be clear and practical, not a dump of complex data. C gets the purpose backwards: education draws the client into active, collaborative treatment. D is also backwards, because good education supports outcomes rather than weakening them. Rule to remember: in CBT-I, education supplies the rationale that drives adherence. An option that links a component to understanding and compliance usually describes its intended role.

Example 3

Question: Which dietary factor, besides caffeine and alcohol, is most associated with sleep disruption?

1. Vitamin D deficiency
2. Large or spicy meals close to bedtime
3. Insufficient protein intake
4. Low carbohydrate diet

Answer: B. Large or spicy meals close to bedtime

Explanation:

B is correct. A large or spicy meal close to bedtime can cause fullness, heartburn and reflux, especially once you lie down, and it keeps digestion active when the body should be winding down. That is why sleep hygiene advice usually pairs caffeine and alcohol limits with guidance on the timing and size of evening meals. A is wrong because vitamin D status is not a standard sleep hygiene target and is not the factor most tied to nightly disruption. C is wrong because protein intake is not a recognized immediate cause of disturbed sleep. D is wrong for the same reason: a low carbohydrate diet is not a core sleep hygiene concern. Rule to remember: sleep hygiene questions favor behaviors close to bedtime and their timing over general nutrition claims.

How to use these practice tests

Read the official BBSM CBTI-C candidate guide before anything else so you know the rules. Then use our sets to find and close gaps.

1. Take a baseline. Run the main practice test without notes and write down which topics cost you points.
2. Core treatment. Work through Sleep Restriction & Stimulus Control and Cognitive Behavioral Techniques & Sleep Interventions. Make sure you can explain each instruction to a client, not just recognize it.
3. Foundations. Pair Sleep Physiology & Disorders with Patient Assessment & Treatment Planning, because assessment questions often depend on ruling out other sleep disorders.
4. Applied topics. Cover Special Populations & Comorbidities, Sleep Hygiene & Lifestyle Factors, Relaxation & Mindfulness, Group Therapy & Digital Delivery, Treatment Outcomes & Research Evidence and Ethical Standards & Professional Practice.
5. Review. For every question you miss, write down the rule behind the right answer, then retake that set a few days later.
6. Final check. Practice under time pressure to rehearse pacing, since the real exam gives you 2.5 hours for 120 items. Confirm your Prometric appointment details in the official guide.

Sources & last verified

1. Board of Behavioral Sleep Medicine — number of questions, exam fee, passing score, retake policy (official source). “The CBTI-C Examination is a computer-based examination composed of 120 scored items with a total testing time of 2.5 hours.” Verified Oct 28, 2026 · source checked Oct 28, 2026.

How we verify: editorial & fact-checking policy. Report an error: contact us.