First-Line Treatments for Insomnia: Focus on CBT-I

<jats:p>Clinical guidelines recommend CBT-I as first-line intervention for insomnia. If severe chronic insomnia causes significant impairment, prioritize pharmacotherapy — alone or combined with CBT-I. The two most potent components of CBT-I are stimulus control and sleep restriction. Sleep restriction is strictly contraindicated in patients with bipolar disorder. Adjust CBT-I sleep restriction by aligning time in bed with actual sleep duration until sleep efficiency reaches 90–95%.</jats:p>