Why insomnia deserves its own treatment
Chronic insomnia is not just a symptom of something else. In long-term studies it precedes and predicts depression and anxiety, and about 80% of people with major depression have disturbed sleep. Treating insomnia directly — rather than waiting for it to resolve when mood improves — is the evidence-supported order of operations.
What CBT-I actually is
Cognitive behavioral therapy for insomnia is a structured program, typically 4 to 8 sessions, that retrains the systems that regulate sleep: consistent wake times, rebuilding the bed-sleep association, temporarily compressing time in bed so sleep consolidates, and unwinding the alarm that builds around sleeplessness itself. Clinical guidelines recommend it as first-line for chronic insomnia — ahead of medication.
What it does for mental health
In randomized trials, CBT-I improved depression in people who had both conditions, and digital versions delivered comparable effects. Most striking: in older adults with insomnia and no depression, CBT-I roughly halved the risk of developing depression over the following three years. Treating sleep is, in a real sense, preventive psychiatric care.
How it fits psychiatric care at Foundry
Foundry reviews sleep at evaluation and at medication follow-ups — psychiatric medications can move sleep in both directions — and refers to CBT-I (therapist-delivered or structured digital programs) when chronic insomnia is part of the picture. Sleep medication, when used, is weighed the way any prescription is: evidence, safety, and a defined role in the plan.
Safety and scope
This guide is general education, not medical advice. It does not create a treatment relationship, diagnose a condition, promise medication, or replace crisis care. For immediate danger use 911, 988, or the nearest emergency department.
Related service
Integrative treatment planning
Integrative treatment planning may include review of sleep, lifestyle, nutrition, supplement use, metabolic health, hormonal transition, pharmacogenomic testing, and complementary approaches when clinically relevant.