Practical tips for paediatricians: implementing cognitive behavioural therapy for adolescent insomnia

Insomnia, a sleep condition defined as persistent difficulties initiating or maintaining sleep, affects up to 40% of adolescents, with most continuing to experience symptoms once they begin. It is linked with mood disturbance, academic impairment, fatigue, and reduced quality of life. Despite its significance, few adolescents seek care on their own, and parents frequently underestimate the issue, highlighting the importance of pediatricians in early detection and treatment. Insomnia must be distinguished from delayed sleep-wake phase disorder (DSWPD), a circadian rhythm condition presenting similar complaints but requiring different treatments. Cognitive behavioural therapy for insomnia (CBT-I) is the first-line treatment recommended for adults and increasingly supported in adolescents. CBT-I integrates behavioural and cognitive strategies to target perpetuating factors and has demonstrated meaningful, durable improvements in sleep outcomes. CBT-I can be delivered in groups, individually, or digitally. Pediatricians can direct access to suitable interventions and offer families guidance on core sleep principles.