Sleep Medicine pp 533-539 | Cite as

Psychological Treatment of Insomnia: The Evolution of Behavior Therapy and Cognitive Behavior Therapy

  • María Montserrat Sánchez-Ortuño
  • Jack D. Edinger


This chapter describes the history of psychological and behavioral therapies for insomnia, from their beginnings in the 1950s to their contemporary developments and applications. Until the mid-80s, various first-generation behavioral insomnia therapies were developed and tested in parallel. Although the nature and specific focus of these therapies varied significantly, the majority of them showed good treatment success. Yet their benefits were best described as moderate. Indeed, none of them represented an omnibus treatment that addressed the range of factors that purportedly sustain insomnia. Therefore, a more comprehensive multicomponent approach, called cognitive-behavioral therapy (CBT), began to gain popularity by the end of the 80s. Since then, there has been a large body of evidence showing that CBT is an effective treatment, mainly for primary insomnia. At the beginning of this millennium, a growing number of studies have demonstrated that CBT is also effective among insomnia patients who additionally suffer from significant sleep-confounding medical and psychiatric disorders. However, it has been argued that the field is not, as yet, at a point where patients can be offered a maximally effective treatment. In an attempt to enhance treatment outcomes, work in progress explores different combinations and treatment sequences of CBT and pharmacotherapy. Moreover, dissemination of this treatment remains as one of its major challenges. To improve its reach, novel strategies including training nontraditional CBT providers and using Web-based treatment delivery methods have received increasing research attention.


Behavioral therapy Cognitive-Behavioral therapy History Primary insomnia Comorbid insomnia 


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Copyright information

© Springer Science+Business Media, LLC 2015

Authors and Affiliations

  • María Montserrat Sánchez-Ortuño
    • 1
  • Jack D. Edinger
    • 2
  1. 1.Facultad de Enfermería, Campus de EspinardoUniversidad de MurciaMurciaSpain
  2. 2.National Jewish HealthDenverUSA

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