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Addressing Daytime Symptoms of Insomnia with CBT-I: An Overview and Practical Applications
Parky H Lau1, Natalie Solomon1, Norah Simpson1
1Department of Psychiatry and Behavioral Medicine, Stanford University School of Medicine, Palo Alto, CA, USA.
Behavioral Sleep Medicine
|June 13, 2026
Summary
Cognitive Behavioral Therapy for Insomnia (CBT-I) can be enhanced by addressing daytime symptoms. Integrating practical strategies improves fatigue and distress, boosting overall treatment effectiveness for chronic insomnia.
Area of Science:
- Sleep Science
- Health Psychology
- Behavioral Medicine
Background:
- Cognitive Behavioral Therapy for Insomnia (CBT-I) is the leading treatment for chronic insomnia, effectively improving sleep quality.
- Standard CBT-I protocols often overlook the direct management of daytime symptoms, such as fatigue and sleepiness.
- Insomnia is increasingly recognized as a 24-hour disorder impacting daily functioning.
Purpose of the Study:
- To provide clinicians with practical, evidence-based strategies for managing daytime symptoms of insomnia.
- To integrate these strategies into existing CBT-I frameworks.
- To enhance the overall efficacy and quality of life outcomes for individuals with chronic insomnia.
Main Methods:
- A literature review was conducted to identify evidence-informed strategies for daytime insomnia symptoms.
- Strategies were drawn from sleep science, circadian science, and health psychology.
- Case formulation approach was used to present and discuss interventions.
Main Results:
- Identified cognitive, behavioral, and acceptance-based strategies to manage daytime fatigue, sleepiness, and distress.
- Provided specific interventions and recommendations for applying these skills to daytime symptoms.
- Demonstrated how these strategies can be integrated within a CBT-I framework.
Conclusions:
- Addressing daytime symptoms is crucial for comprehensive insomnia management.
- Integrating evidence-informed daytime strategies can improve treatment efficacy and quality of life.
- Further research is needed to evaluate the direct impact of these integrated strategies on treatment outcomes.
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