Combining medications with behavioral therapy to treat severe insomnia might not be best for every patient, a new practice guideline states.
Cognitive behavioral therapy (CBT) for insomnia works best on its own. But it can be combined with sleep medications for some patients, according to the April 21, 2026, guideline.
According to the experts of the American Academy of Sleep Medicine, sleep medicines on their own produce the least benefit when treating insomnia. Combination therapy for insomnia is widely used in clinical practice, yet the proof guiding how and when to combine treatments has been shockingly limited.Â
The experts further mentioned that their evaluation suggested that CBT-I by itself is the most effective first-line treatment for insomnia. However, medication with CBT-I may provide modest benefit for some selective outcomes, such as total sleep time.
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According to the background information, 10% to 15% of adults suffer from chronic insomnia. In the past, treatment guidelines suggested either taking medications or undergoing behavioral therapies; however, they did not mention combining the two methods, according to the researchers.
To develop these new guidelines, the American Academy of Sleep Medicine asked a task force of sleep specialists to carefully review the scientific literature on insomnia treatment.
The results indicated that cognitive-behavioral therapy was the most effective approach for helping individuals achieve adequate sleep.
While behavioral therapy alone is capable of producing lasting results with no adverse side effects associated with prescription drugs, according to the researchers, the therapy may also be complemented by the use of medications when deemed necessary.
Nonetheless, the guidelines indicate that the use of sleep medications alone will result in minimal benefits and, therefore, should be done alongside behavioral therapy.
According to the Sleep Foundation, the guidelines instead recommend that people talk to their doctor about what’s best for them.
These recommendations are meant to support thoughtful, patient‑centered decision‑making rather than a one‑size‑fits‑all approach.
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Disclaimer:
This content is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting or changing any medication or treatment.