Insomnia

In Western countries, a third of adults suffer from sleep problems at least once a week, with up to 10% living with insomnia disorder (4). Insomnia can occur at any age and in both sexes but is more common in older adults (ranges from 13% to 60% depending on sample and race) (8) and in females (approximately 1.5 – 2 times higher in females than in males) (9). Approximately half of people diagnosed with insomnia also experience a mental health condition (e.g. depression, anxiety, substance abuse, and post-traumatic stress disorder) (9). Similarly, there is a higher prevalence of insomnia in people with physical health conditions including chronic obstructive pulmonary disease, chronic heart failure, and chronic pain, (9) all of which are common in older adults. Sleep disorders and insomnia are more common in people with intellectual disabilities with rates of 32% experiencing multiple sleep problems in one review (10). Specific sleep disorders can be associated with genetic syndromes or can be associated with comorbid neurodevelopmental disorders.

This information is for commissioners, managers, trainers, and health care practitioners to consider the evidence base for the delivery of psychological interventions for people with insomnia. This information is also for people diagnosed with insomnia, their families, and carers.

This topic introduction page covers evidence-based psychological interventions used to treat insomnia in children, young people, and adults, and the psychological practice/settings in which these interventions can be delivered.

This topic does not cover pharmacological interventions or interventions which are not informed by psychological theory. There are a wider range of non-psychological interventions and supports that are beyond the scope of this topic and full guidance on best practice can be found in NICE Clinical Knowledge Summary Guidance (National Institute for Health and Care Excellence, 2022) (3) and the European Insomnia Guideline (2023) (4).

A range of psychological interventions have been listed in the treatment table for people with insomnia. To be consistent with our focus on interventions with the highest levels of efficacy and the strongest levels of evidence, where these exist, psychological interventions for insomnia with low strength evidence and low levels of efficacy have not been included. The evidence tables below include interventions with low to high levels of evidence and small to large levels of efficacy on sleep and insomnia outcomes. The evidence is obtained from systematic reviews/meta-analysis and RCTs of psychological interventions.

The majority of studies presented below are conducted in white, western clinical populations. However, global cross-cultural differences in sleep expectations, routines, and presentation are also widely documented (11). In order to support optimised sleep whilst avoiding the imposition of an inappropriate cultural lens, clinicians should be aware of the person’s cultural context and adapt sleep formulation and intervention appropriately (12).

Evidence Overview for Children and Young People (CYP)

Advice on sleep hygiene can be considered as part of a supported package of interventions for short-term sleep difficulties in children and young people (3). NICE recommends Cognitive Behavioural Therapy for Insomnia (CBT-I) as the next step for short-term insomnia, but as first-line treatment for long-term insomnia (3). This recommendation is supported by moderate quality evidence of medium to large effect sizes for CBT-I across several insomnia outcomes (including total sleep time, sleep onset latency, sleep efficiency, and wake after sleep onset) (13,14) as well as on depression and anxiety outcomes (15). Moderate quality evidence reporting small to large effect sizes across insomnia outcomes (sleep-onset latency, number of night wakings/duration of night wakings, and sleep efficiency) supports the delivery of behavioural interventions (including interventions with a behavioural component) for children and young people with insomnia (16). Behavioural interventions have been shown to be effective across various sleep related outcomes for young people with a diagnosis of autistic spectrum disorder (17,18). Behavioural interventions for sleep insomnia can also be applied with infants over 12 months (19) (it is not recommended in infants under 12 months due to increased risk of Sudden Infant Death Syndrome. See baby sleep info source https://www.basisonline.org.uk/) with parents engaging in CBT-I treatment to support the intervention (14). Emerging evidence indicates that mindfulness components combined with CBT-I or Mindfulness Based Stress Reduction CBT-I can also be associated with improvements across insomnia related outcomes in adolescents with poor sleep quality and anxiety, however findings are mixed and quality of existing studies is variable (20,21) so these are included in the table an alternative approach.  

Young people with a diagnosis of ASD have a vastly increased prevalence of insomnia and sleep disturbance compared to the general population (22). Moderate quality evidence shows small to large effect sizes across outcome for CBT and behavioural interventions, with large heterogeneity reported amongst intervention type, duration, and delivery (17,18,23) and one review showing emerging evidence of wider positive impacts of behavioural sleep interventions on children’s daytime functioning and wellbeing (24). It is recommended that all interventions are made accessible for young people and are viewed systemically with parental support and training at their core.

Evidence Overview for Adults

Sleep hygiene education can form part of care for short-term insomnia (3). In long-term insomnia, Cognitive Behavioural Therapy for Insomnia (CBT-I) should be offered and this can include sleep hygiene education (3,4). The recommendation for CBT-I is made in the NICE Clinical Knowledge Summary and the ‘European guideline for the diagnosis and treatment and of insomnia’ (4). High quality evidence reporting small to large effect sizes on several insomnia outcomes (including insomnia symptoms, insomnia severity, sleep efficiency, sleep quality, sleep onset latency) provide support for this (25-28). CBT-I can be delivered face-to-face, in groups (29) or digitally  (3,30) with larger effect sizes associated with CBT-I delivered with synchronous support and with guided digital interventions compared to self-guided digital delivery (27,30,31) and other self-help interventions (31). Good quality evidence demonstrating the effectiveness of Sleepio in insomnia provides support for its recommendation by NICE (3) especially as Sleepio offers increased opportunities for access to cost-effective CBT-I, and increases the available options for management of insomnia in primary care (32) beyond sleep hygiene education and second line medications typically used for insomnia management in Primary Care.

Moderate quality evidence reporting medium to large effect sizes suggest the effectiveness of Sleep Restriction Therapy (SRT) on several insomnia outcomes (including insomnia severity, sleep efficiency, sleep onset latency, wake-time after sleep onset) as well as effects on mental health and quality of life (33,34). There is evidence emerging regarding the effectiveness of Mindfulness-based interventions (MBIs) (35-37) and Acceptance and Commitment Therapy (ACT) in insomnia management. Two contemporary meta-analyses concerning mindfulness-based treatments for insomnia show positive effects (36,37). The number of studies in this area, however, is still relatively small, and the authors of both meta-analyses state that long-term effects need to be investigated more thoroughly. ACT has been studied only in small randomised clinical studies. While ACT was shown to be superior to an active control condition (38), it was inferior to CBT-I (39). Moreover, replacing the cognitive therapy aspect of CBT-I with ACT did not enhance efficacy (39). Finally, one study of a web-based treatment platform using ACT, SRT and SCT found it was superior to waitlist control conditions (40). In summary, there is some evidence that ACT may be effective in insomnia; however, larger randomised clinical studies are required. Research of Mindfulness based interventions (35,36) thus far indicates weaker effects than CBT or SRT, as such these interventions are included as an alternative.

Evidence for Older Adults

There is strong evidence that as with younger adults CBT-I and brief behavioural interventions are suitable for Older Adults and limited evidence to support mindfulness interventions, with some suggested modifications (8). Clinicians are advised that there are differences in presentation of psychological problems in later life and to consult Delivering Psychological Therapies and Interventions for Older People for further information on factors relevant to practice. 

Evidence for learning disabilities

Research specifically relating to psychological interventions for insomnia in children, young people and adults who have intellectual disabilities is mainly limited to case series studies, partly due to the difficulties in implementing standard research methodologies and identifying a critical mass. Some evidence on interventions primarily with children can be derived from specific populations with concomitant sleep-related disorders such as Smith-Magenis Syndrome, Downs Syndrome, Angelman Syndrome and Prader-Willi Syndrome (41-50). Meltzer and Mindell (2014) report low efficacy for behavioural interventions in children and young people with neurodevelopmental differences but suggest further investigation is required in this population due to a paucity of studies (51).

There can be challenges with diagnosis and identification of associated issues (52) but difficulties can originate more frequently from co-morbidities such as epilepsy, respiratory disorders, visual impairment, self-injurious or stereotyped behaviour and there is evidence to suggest sleep problems are of a higher prevalence in this population (53). Some studies report a reticence to sleep alone in adults with autism (54-56). NICE (2015) recommends functional analysis to inform the intervention relating to problem sleep behaviours and consideration of behavioural interventions including structured bedtime routines (57). A systematic review of interventions for insomnia in adults with intellectual disabilities (58) identified limited, low quality, evidence consisting of case reports and case series. Two out of the nine included papers involved psychological interventions (with others involving medication and other non-psychological interventions). These case series indicated efficacy for interventions including sleep hygiene (59), behavioural approaches (sleep scheduling, stimulus control and relaxation) and CBT (46,60) with mixed age groups. Similarly, van de Wouw et al (2012) concluded that there was evidence of efficacy of behavioural interventions for sleep problems exacerbated by medication and challenging behaviour. They reviewed 50 studies in adults with intellectual disabilities but without statistical analysis. A meta-analysis (61) across the lifespan reported a 53% improvement from baseline for behavioural interventions in single case experimental designs. However, follow up data is less consistent. 

Psychological interventions should be informed by formulation and adapted to the individual with modifications for CBT-I for adults with intellectual disabilities (52). Some guidance on adapting sleep interventions, such as CBT-I for people with intellectual disabilities can be found in a recent review (52).

Like all treatments, psychological therapies have the potential to have adverse effects. Until recently, information on potential harms and rates of adverse effects have not been gathered systematically (see information relating to safety in the delivery of psychological therapies). Reports of adverse events are increasingly included in research trials and gathered as part of service provision. Sleep Reduction Therapy is associated with increased tiredness and sleepiness, and there is evidence from both controlled and uncontrolled trials of objectively reduced vigilance during the first weeks of implementation (33,62,63). The initial restriction of time in bed and its associated sleepiness may be central to therapeutic effects of behavioural treatment (64).  Espie and colleagues (2019) (65) showed that CBT-I was associated with higher reports of intervention-attributed adverse effects (extreme sleepiness, fatigue or exhaustion, attention and concentration problems, low motivation and energy, headaches, memory difficulties and irritability) relative to sleep hygiene. Sunnhed and colleagues (2020) localised adverse effects, especially fatigue and sleepiness, to behavioural therapy (SRT, SCT) relative to cognitive therapy (66). However, the largest trial to date (67), found no evidence that Sleep Reduction Therapy was associated with serious adverse events, or increased incidence of pre-defined adverse events (e.g. falls and accidents) relative to sleep hygiene control. 

Care should be taken when administering SRT and/or stimulus control protocols, including initial assessment for suitability and ongoing reviews of sleepiness (and impact on driving) during treatment, with appropriate adaptations put in place where necessary. Contraindications for treatments that involve partial sleep deprivation include any kind of epilepsy and conditions that might be aggravated by sleep loss. Clients and clinicians should be familiar with risk–benefit considerations when making treatment decisions (4).

The low probability of serious or enduring adverse effects with CBT-I is considered a strong advantage over pharmacological treatments (4).

With thanks to Chris Millar and Alisdair Henry from Big Health/University of Oxford and to Alyson O'Brien from Sleep Action for their feedback on the content. Thanks also to Chris Wright who participated in the advisory group.

Technical group:  Audrey Espie, Colin Espie, Leeanne Nicklas, Marie Claire Shankland, Shreena Unadkat.

1.ICD-11 for Mortality and Morbidity Statistics2022; Available at: https://icd.who.int/dev11/l-m/en. Accessed Apr 9, 2025.

2.World Health Organisation. ICD-11 for Mortality and Morbidity Statistics2022; Available at: https://icd.who.int/browse/2025-01/mms/en. Accessed May 8, 2025.

3.National Institute for Health and Care Excellence. 1 Recommendations | Sleepio to treat insomnia and insomnia symptoms | Guidance | NICE2022; Available at: https://www.nice.org.uk/guidance/mtg70/chapter/1-Recommendations. Accessed May 8, 2025.

4.Riemann D, Espie CA, Altena E, Arnardottir ES, Baglioni C, Bassetti CLA, et al. The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023. J Sleep Res 2023 -12;32(6):e14035.

5.Espie C.A., Kyle S.D., Hames P., Gardani M., Fleming L., Cape J. The Sleep Condition Indicator: A clinical screening tool to evaluate insomnia disorder. BMJ Open 2014;4(3) (pagination):Article Number: e004183. Date of Publication: 2014.

6.Carney C.E., Buysse D.J., AncoliIsrael S., Edinger J.D., Krystal A.D., Lichstein K.L., et al. The consensus sleep diary: Standardizing prospective sleep self-monitoring. Sleep 2012;35(2):287–302.

7.National Institute for Health and Care Excellence. Management | Insomnia | CKS | NICE2025; Available at: https://cks.nice.org.uk/topics/insomnia/management/. Accessed May 8, 2025.

8.Dzierzewski JM, Griffin SC, Ravyts S, Rybarczyk B. Psychological Interventions for Late-life Insomnia: Current and Emerging Science. Current Sleep Medicine Reports 2018 Dec;4(4):268–277.

9.Wilson S., Anderson K., Baldwin D., Dijk D.J., Espie A., Espie C., et al. British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: An update. Journal of Psychopharmacology 2019;33(8):923–947.

10.Van de Wouw E., Evenhuis H.M., Echteld MA. Prevalence, associated factors and treatment of sleep problems in adults with intellectual disability: A systematic review. Res Dev Disabil 2012;33(4):1310–1332.

11.Jeon M, Dimitriou D, Halstead EJ. A Systematic Review on Cross-Cultural Comparative Studies of Sleep in Young Populations: The Roles of Cultural Factors. International Journal of Environmental Research & Public Health [Electronic Resource] 2021;18(4):02 19.

12.Crowther ME, Saunders WJ, Sletten TL, Drummond SPA, Bei B. Tailoring cognitive behavioural therapy for insomnia across contexts, conditions, and individuals: What do we know, where do we go? J Sleep Res 2023 -12;32(6):e14023.

13.Blake MJ, Sheeber LB, Youssef GJ, Raniti MB, Allen NB. Systematic Review and Meta-analysis of Adolescent Cognitive-Behavioral Sleep Interventions. Clinical Child & Family Psychology Review 2017;20(3):227–249.

14.Ma Z, Shi L, Deng M. Efficacy of cognitive behavioral therapy in children and adolescents with insomnia: a systematic review and meta-analysis. Brazilian Journal of Medical & Biological Research 2018;51(6):e7070.

15.Reddy A., Mansuri Z., Vadukapuram R., Shah K., Thootkur M., Trivedi C. Efficacy of Cognitive Behavioral Therapy for Insomnia for the Treatment of Child and Adolescent Anxiety and Depression: A Systematic Review from Randomized Controlled Trials. J Nerv Ment Dis 2023;211(3):238–243.

16.Meltzer LJ, Mindell JA. Systematic review and meta-analysis of behavioral interventions for pediatric insomnia. J Pediatr Psychol 2014 -09;39(8):932–948.

17.Pattison E, Papadopoulos N, Marks D, McGillivray J, Rinehart N. Behavioural Treatments for Sleep Problems in Children with Autism Spectrum Disorder: a Review of the Recent Literature. Curr Psychiatry Rep 2020;22(9):46.

18.McCrae CS, Chan WS, Curtis AF, Deroche CB, Munoz M, Takamatsu S, et al. Cognitive behavioral treatment of insomnia in school-aged children with autism spectrum disorder: A pilot feasibility study. Autism research : Official Journal of the International Society for Autism Research 2020;13(1):167–176.

19.Kahn M., JudaHanael M., LivneKarp E., Tikotzky L., Anders T.F., Sadeh A. Behavioral interventions for pediatric insomnia: One treatment may not fit all. Sleep 2020;43(4) (pagination):Date of Publication: 01 Ar 2020.

20.Blake M, Schwartz O, Waloszek JM, Raniti M, Simmons JG, Murray G, et al. The SENSE Study: Treatment Mechanisms of a Cognitive Behavioral and Mindfulness-Based Group Sleep Improvement Intervention for At-Risk Adolescents. Sleep 2017;40(6):06 01.

21.Garbers S, Umar NQ, Hand RE, Usseglio J, Gold MA, Bruzzese J. Mind-Body Integrative Health (MBIH) Interventions for Sleep among Adolescents: A Scoping Review of Implementation, Participation and Outcomes. Adolescent Research Review 2022 Dec;7(4):565–589.

22.Shelton A.R., Malow B. Treatment of insomnia in children and adolescents with autism spectrum disorder. The Lancet.Child & adolescent health 2020;4(10):716–717.

23.Papadopoulos N., Sciberras E., Hiscock H., Williams K., McGillivray J., Mihalopoulos C., et al. Sleeping Sound Autism Spectrum Disorder (ASD): a randomised controlled trial of a brief behavioural sleep intervention in primary school-aged autistic children. J Child Psychol Psychiatry 2022;63(11):1423–1433.

24.Hunter J.E., McLay L.K., France K.G., Blampied NM. Systematic review of the collateral effects of behavioral sleep interventions in children and adolescents with autism spectrum disorder. Research in Autism Spectrum Disorders 2020;79(pagination):Article Number: 101677. Date of Publication: 01 Nov 2020.

25.Saruhanjan K., Zarski A.C., Bauer T., Baumeister H., Cuijpers P., Spiegelhalder K., et al. Psychological interventions to improve sleep in college students: A meta-analysis of randomized controlled trials. J Sleep Res 2021;30(1) (pagination):Article Number: e13097. Date of Publication: 01 Feb 2021.

26.Davidson J.R., Dickson C., Han H. Cognitive behavioural treatment for insomnia in primary care: A systematic review of sleep outcomes. British Journal of General Practice 2019;69(686):E657–E664.

27.Soh H.L., Ho R.C., Ho C.S., Tam WW. Efficacy of digital cognitive behavioural therapy for insomnia: a meta-analysis of randomised controlled trials. Sleep Med 2020;75:315–325.

28.van Straten A., van der Zweerde T., Kleiboer A., Cuijpers P., Morin C.M., Lancee J. Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis. Sleep Medicine Reviews 2018;38:3–16.

29.Koffel E.A., Koffel J.B., Gehrman PR. A meta-analysis of group cognitive behavioral therapy for insomnia. Sleep Medicine Reviews 2015;19:6–16.

30.Hasan F, Tu Y, Yang C, James Gordon C, Wu D, Lee H, et al. Comparative efficacy of digital cognitive behavioral therapy for insomnia: A systematic review and network meta-analysis. Sleep Medicine Reviews 2022;61:101567.

31.Simon L., Steinmetz L., Feige B., Benz F., Spiegelhalder K., Baumeister H. Comparative efficacy of onsite, digital, and other settings for cognitive behavioral therapy for insomnia: a systematic review and network meta-analysis. Scientific reports 2023;13(1):1929.

32.1 Recommendations | Sleepio to treat insomnia and insomnia symptoms | Guidance | NICE2022; Available at: https://www.nice.org.uk/guidance/mtg70/chapter/1-Recommendations. Accessed Apr 9, 2025.

33.Maurer L.F., Schneider J., Miller C.B., Espie C.A., Kyle SD. The clinical effects of sleep restriction therapy for insomnia: A meta-analysis of randomised controlled trials. Sleep Medicine Reviews 2021;58(pagination):Article Number: 101493. Date of Publication: 01 Aug 2021.

34.Kyle S.D., Bower P., Yu L.M., Siriwardena A.N., Yang Y., Ogburn E., et al, editors. Clinical and cost-effectiveness of nurse-delivered sleep restriction therapy for insomnia in primary care: A pragmatic, multicentre, randomised controlled trial Journal of Sleep Research. Conference: 26th Conference of the European Sleep Research Society. Athens Greece. 31(Supplement 1) (no pagination); Blackwell Publishing Ltd; 2022.

35.Rusch H.L., Rosario M., Levison L.M., Olivera A., Livingston W.S., Wu T., et al. The effect of mindfulness meditation on sleep quality: a systematic review and meta-analysis of randomized controlled trials. Ann N Y Acad Sci 2019;1445(1):5–16.

36.Wang Y.Y., Wang F., Zheng W., Zhang L., Ng C.H., Ungvari G.S., et al. Mindfulness-Based Interventions for Insomnia: A Meta-Analysis of Randomized Controlled Trials. Behavioral sleep medicine 2020;18(1):1–9.

37.Chen T, Chang S, Hsieh H, Huang C, Chuang J, Wang H. Effects of mindfulness-based stress reduction on sleep quality and mental health for insomnia patients: A meta-analysis. J Psychosom Res 2020;135:110144.

38.Zakiei A, Khazaie H, Rostampour M, Lemola S, Esmaeili M, Dürsteler K, et al. Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia-Results from a Randomized Interventional Study. Life (Basel) 2021 -02-09;11(2):133.

39.El Rafihi-Ferreira R, Morin CM, Toscanini AC, Lotufo Neto F, Brasil IS, Gallinaro JG, et al. Acceptance and commitment therapy-based behavioral intervention for insomnia: a pilot randomized controlled trial. Braz J Psychiatry 2021;43(5):504–509.

40.Chapoutot M, Peter-Derex L, Schoendorff B, Faivre T, Bastuji H, Putois B. Telehealth-delivered CBT-I programme enhanced by acceptance and commitment therapy for insomnia and hypnotic dependence: A pilot randomized controlled trial. J Sleep Res 2021 -02;30(1):e13199.

41.Stores G., Stores R. Sleep disorders and their clinical significance in children with Down syndrome. Dev Med Child Neurol 2013;55(2):126–130.

42.Harvey MT, Baker DJ, Horner RH, Blackford JU. A Brief Report on the Prevalence of Sleep Problems in Individuals with Mental Retardation Living in the Community. Journal of Positive Behavior Interventions 2003;5(4):195–200.

43.Hodge D., Parnell A.M.N., Hoffman C.D., Sweeney DP. Methods for assessing sleep in children with autism spectrum disorders: A review. Research in Autism Spectrum Disorders 2012;6(4):1337–1344.

44.Esbensen A.J., Hoffman E.K., Beebe D.W., Byars K., Carle A.C., Epstein J.N., et al. Randomized Behavioral Sleep Clinical Trial to Improve Outcomes in Children With Down Syndrome. American journal on intellectual and developmental disabilities 2022;127(2):149–164.

45.Richdale A, Wiggs L. Behavioral approaches to the treatment of sleep problems in children with developmental disorders: What is the state of the art? International Journal of Behavioral Consultation and Therapy 2005 23;1(3):165–190.

46.Richdale AL, Baker EK. Sleep in Individuals with an Intellectual or Developmental Disability: Recent Research Reports. Curr Dev Disord Rep 2014 June 1;1(2):74–85.

47.Espie CA, Tweedie FM. Sleep patterns and sleep problems amongst people with mental handicap. J Ment Defic Res 1991 Feb;35(Pt 1):25–36.

48.Espie CA, Paul A, McFie J, Amos P, Hamilton D, McColl JH, et al. Sleep studies of adults with severe or profound mental retardation and epilepsy. Am J Ment Retard 1998 -07;103(1):47–59.

49.Allen KD, Kuhn BR, DeHaai KA, Wallace DP. Evaluation of a behavioral treatment package to reduce sleep problems in children with Angelman Syndrome. Res Dev Disabil 2013 -01;34(1):676–686.

50.Wiggs L, Stores G. Behavioural treatment for sleep problems in children with severe intellectual disabilities and daytime challenging behaviour: effect on mothers and fathers. Br J Health Psychol 2001 -09;6(Pt 3):257–269.

51.Meltzer LJ, Mindell JA. Systematic review and meta-analysis of behavioral interventions for pediatric insomnia. J Pediatr Psychol 2014 Sep;39(8):932–948.

52.Korb L., O'Regan D., Conley J., Dillon E., Briggs R., Courtenay K., et al. Sleep: the neglected life factor in adults with intellectual disabilities. BJPsych Bulletin 2023;47(3):139–145.

53.Agar G, Brown C, Sutherland D, Coulborn S, Oliver C, Richards C. Sleep disorders in rare genetic syndromes: a meta-analysis of prevalence and profile. Mol Autism 2021 -02-25;12(1):18.

54.Elrod MG, Hood BS. Sleep differences among children with autism spectrum disorders and typically developing peers: a meta-analysis. J Dev Behav Pediatr 2015 -04;36(3):166–177.

55.Cohen S, Fulcher BD, Rajaratnam SMW, Conduit R, Sullivan JP, St Hilaire MA, et al. Sleep patterns predictive of daytime challenging behavior in individuals with low-functioning autism. Autism Res 2018 -02;11(2):391–403.

56.Baker E, Richdale A, Short M, Gradisar M. An investigation of sleep patterns in adolescents with high-functioning autism spectrum disorder compared with typically developing adolescents. Dev Neurorehabil 2013 -06;16(3):155–165.

57.No titleNational Institute for Health and Care Excellence (NICE) 2015 National Institute for Health and Care Excellence: Guidelines 05.

58.Shanahan P.J., Palod S., Smith K.J., FifeSchaw C., Mirza N. Interventions for sleep difficulties in adults with an intellectual disability: a systematic review.Journal of Intellectual Disability Research 2019;63(5):372–385.

59.Spruyt K, Curfs LMG. Non-pharmacological management of problematic sleeping in children with developmental disabilitiesDev Med Child Neurol 2015 -02;57(2):120–136.

60.Rigney G, Ali NS, Corkum PV, Brown CA, Constantin E, Godbout R, et al. A systematic review to explore the feasibility of a behavioural sleep intervention for insomnia in children with neurodevelopmental disorders: A transdiagnostic approachSleep Med Rev 2018 -10;41:244–254.

61.Priday LJ, Byrne C, Totsika V. Behavioural interventions for sleep problems in people with an intellectual disability: a systematic review and meta-analysis of single case and group studiesJ Intellect Disabil Res 2017 -01;61(1):1–15.

62.Kyle S.D., Miller C.B., Rogers Z., Siriwardena A.N., Macmahon K.M., Espie CA. Sleep restriction therapy for insomnia is associated with reduced objective total sleep time, increased daytime somnolence, and objectively impaired vigilance: Implications for the clinical management of insomnia disorder.Sleep 2014;37(2):229–237.

63.Maurer LF, Espie CA, Omlin X, Emsley R, Kyle SD. The effect of sleep restriction therapy for insomnia on sleep pressure and arousal: a randomized controlled mechanistic trial.Sleep 2022;45(1):01 11.

64.Maurer L.F., Espie C.A., Omlin X., Reid M.J., Sharman R., Gavriloff D., et al. Isolating the role of time in bed restriction in the treatment of insomnia: A randomized, controlled, dismantling trial comparing sleep restriction therapy with time in bed regularization.Sleep 2020;43(11) (pagination):Article Number: zsaa096. Date of Publication: 01 Nov 2020.

65.Espie CA, Emsley R, Kyle SD, Gordon C, Drake CL, Siriwardena AN, et al. Effect of Digital Cognitive Behavioral Therapy for Insomnia on Health, Psychological Well-being, and Sleep-Related Quality of Life: A Randomized Clinical Trial.JAMA Psychiatry 2019;76(1):21–30.

66.Sunnhed R., Hesser H., Andersson G., Carlbring P., Morin C.M., Harvey A.G., et al. Comparing internet-delivered cognitive therapy and behavior therapy with telephone support for insomnia disorder: A randomized controlled trial.Sleep 2020;43(2) (pagination):Date of Publication: 01 Feb 2020.

67.Kyle S.D., Siriwardena A.N., Espie C.A., Yang Y., Petrou S., Ogburn E., et al. Clinical and cost-effectiveness of nurse-delivered sleep restriction therapy for insomnia in primary care (HABIT): a pragmatic, superiority, open-label, randomised controlled trial.The Lancet 2023;402(10406):975–987.

68.Korb L, O'Regan D, Conley J, Dillon E, Briggs R, Courtenay K, et al. Sleep: the neglected life factor in adults with intellectual disabilitiesBJPsych Bull 2023 -06;47(3):139–145.