CBT-I [cognitive behavioral therapy – insomnia] is the most effective psychology-based treatment for a health problem and has consistently been proven to be the most effective first-line treatment for chronic insomnia. It improves sleep in 75 to 80 percent of insomnia patients and reduces or eliminates sleeping pill use in 90 percent of patients. It is so effective that I am surprised if my patients do not report improvement in sleep, or a reduction or elimination of sleeping pills, from CBT-I. And in three studies published in major medical journals that directly compared CBT with sleeping pills, including my study at Harvard Medical School, CBT-I was more effective than sleeping pills. CBT-I also has no side effects and maintains improvements in sleep long-term, and new research shows that CBT-I doubles the improvement rates of depression compared with antidepressant medication alone in depressed patients with insomnia.
In contrast to CBT-I, sleeping pills do not greatly improve sleep. Objectively, newer-generation sleeping pills such as Ambien are no more effective than a placebo.