Combining medications with behavioral therapy to treat chronic insomnia might not be best for all patients, a new practice guideline says.
FRIDAY, April 24, 2026 — Combining medications with behavioral therapy to treat chronicCognitive behavioral therapy for insomniameds for some patients, according to the guideline published in theSleep meds on their own produce the least benefit when treating insomnia, researchers found.
“Combination therapy for insomnia is widely used in clinical practice, yet the evidence guiding how and when to combine treatments has been surprisingly limited,” said lead researcher Dr. Daniel Buysse, a professor of psychiatry, medicine, and clinical and translational science at the University of Pittsburgh. “Our analysis suggests that CBT-I by itself is the most efficacious first-line treatment for insomnia,” he said in a news release.
“However, using medication with CBT-I may provide modest benefit for some specific outcomes, such as total sleep time. ” Between 10% and 15% of adults are affected by chronic insomnia, researchers said in background notes. Previously, guidelines recommended either using medications or behavioral therapy, but did not address combining the two approaches, researchers noted.
To craft these new recommendations, the American Academy of Sleep Medicine commissioned a task force of sleep experts to systematically review the existing evidence related to treatments for insomnia. Results showed that cognitive-behavioral therapy was the best way to help people get the sleep they needed. Behavioral therapy by itself produces meaningful and durable improvements without the side effects that can come from prescription meds, researchers concluded.
The guidelines said using sleep drugs on their own produced the least benefit, and should be used in combination with behavioral therapy.
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