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Rain Dance Press

CBT-I — What It Is

CBT-I is the standard, evidence-based treatment for chronic insomnia, and most of it is practice rather than pharmacy. This page explains the method, and what our app is an early concept for.

This app is a concept — there is no app to download yet. What follows is partly a description of CBT-I itself, which is an established clinical method we did not invent, and partly a sketch of what we are exploring. Nothing here is a promise about a product, and there is no date attached to anything.

What CBT-I is

Cognitive behavioral therapy for insomnia is a structured, time-limited program. It is not counselling in the general sense, and it is not sleep-hygiene advice with a clinical name attached. It is a defined set of procedures delivered over a handful of weeks, and it is recommended as the first-line treatment for chronic insomnia in major clinical guidelines — ahead of medication, not behind it.

The reason is straightforward. Sleeping pills generally act quickly and stop working when they are stopped. CBT-I takes longer to take effect and the improvement tends to hold, because what changes is the habit and the association rather than the chemistry.

What the method consists of

Four components do most of the work, and none of them require a prescription.

  • A sleep diary. A couple of weeks of when sleep was attempted, when it ended, and how much of the time in between was actually spent asleep. Everything else in the method is built on this record.
  • Consolidating the time in bed. Rather than spending longer in bed in the hope of sleeping, the time allotted to bed is initially narrowed to match the sleep actually being obtained, then widened again as it fills. This is the component that surprises people, and the central one. It is also the reason the method is normally followed with guidance rather than alone.
  • Rebuilding the association. The bed is reconnected to sleeping. Time awake in bed is not spent in bed, so that the bed stops being the place where the night is spent lying awake.
  • Working on the thoughts. The anxious arithmetic of a bad night — how many hours remain, what tomorrow will cost — is addressed directly, because that calculation is part of what sustains the arousal in the first place.

Why we are interested in it

Because it is the rare treatment that is genuinely first-line, genuinely effective, and genuinely hard to keep up. The method is not complicated. Staying with it over several weeks without someone checking in is. That gap — between a protocol people are told to follow and a protocol people manage to follow — is the only interesting problem in this space.

An app is a plausible place to narrow it. That is the whole of the concept at this stage.

Where the concept stands

  • It is one of four apps in development at Rain Dance Press, and the least developed of them — there is a design brief but no code yet.
  • The name CBT-I is the clinical term for the therapy rather than a chosen product name. If this ships it will most likely ship under something friendlier, in the way our books are named.
  • Digital CBT-I is an active field with several companies already working in it, so a freedom-to-operate review comes before anything is built rather than after.
  • When there is something concrete to say, it will appear on the app page.

What it will not be

  • Not therapy, and not a substitute for it. An app can support a practice. It cannot assess anyone, and it cannot judge whether CBT-I is appropriate for them.
  • Not a diagnosis. Insomnia has causes that are worth ruling out, and ruling them out is a clinician's job, not an app's.
  • Not a place your data goes. Everything we build is local: no account, no analytics, no tracking.

If sleep is a medical concern

Chronic insomnia is a matter for a clinician rather than an app. CBT-I is well established, and a clinician or a qualified practitioner can say whether it is the right starting point for a particular person — and, just as importantly, can help them stay with it, which is most of the battle.

This page is educational information, not medical advice. Always consult your healthcare provider with questions about your health.

Privacy

The app is being designed with no account, no login, no analytics, no advertising, and nothing about you collected. See the privacy policy for this app and our company-wide Privacy Policy.

Questions? Support reaches a person.