Less Time in Bed, More Consolidated Sleep

CBT-I asks some people to spend less time in bed, which sounds backwards. The goal is not less sleep. It is less time lying awake, and a stronger link between bed and sleep.

This is Part 1 of a five-part series on sleep and mental health. The other parts cover The Harder You Try, the Further It Gets, You’re Not Weak. It May Be Rebound, He Can’t Fall Asleep. It May Not Be Defiance, and Sleep Was the First Thing to Change.

You may be spending nine hours in bed and sleeping for six. So why would a treatment ask you to spend less time there? The answer is not to starve you of sleep. Cognitive behavioral therapy for insomnia, or CBT-I, can make sleep more settled by matching time in bed more closely to the sleep you are getting now. It also helps rebuild the link between bed and sleep. This article explains that counterintuitive plan, especially time-in-bed restriction or compression and stimulus control. It does not give you a sleep-window formula. Total sleep may not rise at first. Some people need a gentler or closely monitored plan. The next safe step is to confirm that chronic insomnia fits, screen for risks, and build the plan with a trained clinician.

Key takeaways

• U.S. guidelines recommend multicomponent CBT-I as the initial treatment for chronic insomnia in many adults.1 2 3
• Sleep hygiene alone is not CBT-I. Full treatment combines behavioral work, cognitive work, monitoring, and relapse planning.2 3 4
• The early goal is usually less wakefulness in bed and lower insomnia distress, not a promise of more total sleep.
• Some people feel more tired or sleepy early on. A driving near miss, fall, seizure, marked mood change, or other safety concern means the plan needs review.

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What chronic insomnia is, and what it is not

Chronic insomnia disorder is more than a rough week. It involves repeated trouble falling asleep, staying asleep, or returning to sleep. The problem continues for months. It happens despite a real chance to sleep and causes distress or trouble during the day.3 4

Current criteria use sleep trouble at least three nights each week for at least three months, plus daytime effect and enough chance to sleep. A public article cannot confirm the diagnosis.

That last part matters. Work, caregiving, pain, noise, or an unsafe home may leave too little chance to sleep. That is not the same as insomnia. A late body clock may also clash with a required schedule. Loud snoring, gasping, restless legs, unusual nighttime behavior, or sudden sleep attacks point toward another sleep problem. More than one condition can exist at once.

Insomnia is mainly understood through your history and your experience. A sleep study is not required for an uncomplicated case. Testing can be useful when a clinician suspects sleep apnea, narcolepsy, a movement disorder, or another condition.3 10

Do not call every bad night chronic insomnia. Do not expect CBT-I alone to fix apnea, a timing problem, medicine effects, or too little sleep opportunity.

Why CBT-I comes first for many adults

The American College of Physicians recommends CBT-I as the initial treatment for adults with chronic insomnia. The American Academy of Sleep Medicine strongly recommends multicomponent CBT-I. The 2025 VA/DoD guideline also gives it a strong recommendation.1 2 3

First-line means the preferred starting choice for a defined group. It does not mean only treatment. Apnea, depression, anxiety, pain, substance use, or another condition may need care at the same time. Some people also use insomnia medicine. A 2026 AASM guideline found low-certainty evidence that adding medicine did not give a clear advantage over CBT-I alone for global insomnia, continuity, or daytime outcomes. A combined plan can still fit some patient goals.10 11

Access is part of the decision. Care may be far away or costly. It may not use your language or fit around work and family. Groups, telehealth, brief care, and supported digital care may help. They are not all equal. An app is not automatically trained care.

CBT-I is a treatment package, not a list of bedtime tips

CBT-I usually brings several parts together:

1. Time-in-bed restriction or compression changes the planned time in bed so it is closer to the sleep a person is getting now. Restriction makes the change more directly. Compression makes it in smaller steps.
2. Stimulus control changes the learned pattern around the bed. It aims to make bed a stronger cue for sleep rather than for long periods of worry, frustration, work, or watching the clock.
3. Cognitive work examines predictions such as, “If I do not sleep tonight, tomorrow will be a disaster.” It does not ask you to pretend that sleep loss has no effect.
4. Counter-arousal skills may include relaxation or another way to lower tension. The skill is a tool, not a test you must pass.
5. Sleep education and monitoring help you understand patterns and make changes from real data.
6. Relapse planning prepares for travel, illness, caregiving, stress, and schedule changes.

Sleep hygiene can support this work. It may address caffeine, light, noise, or an uncomfortable room. But the AASM suggests against using sleep hygiene as the only treatment for chronic insomnia.2 A handout that says “avoid screens and keep the room cool” is not full CBT-I.

The “must keep” items come from tested packages or current guidance. The adaptations are practical extensions, not one proven recipe for everyone.

The bookbinder’s press: a useful image with a firm limit

Picture a bookbinder gathering loose pages before pressing and binding them into one block. The press does not add pages. It brings them into a more coherent form.

Time-in-bed work has a similar teaching purpose. A person may spend many hours in bed, with sleep scattered between long awake periods. A carefully chosen plan can reduce some of that awake time in bed. Sleep may become more continuous and satisfying. The plan can then be adjusted as sleep and daytime function change.

The image has a limit. A book press is not a sleep-window calculator. Human sleep is not paper. Tighter is not always better. The plan must protect alertness, mood, movement, caregiving, and health. It should never display a fixed number of hours or invite you to make your own restriction schedule.

What time-in-bed work is trying to change

Time-in-bed restriction does not keep you awake for its own sake. The plan uses your recent sleep, health, schedule, and safety. A clinician reviews sleep, daytime function, and burden. Time in bed then changes as needed.

Sleep compression aims for a similar endpoint through smaller changes. In a 2025 Swedish trial of 234 adults, both guided online methods helped. Compression did not meet the set test for being no worse than restriction. It worked more slowly, but people followed it better and had somewhat fewer side effects.7 It is a possible adaptation, not a proven equal choice.

Stimulus control works on another part of the pattern. Bed may have become a place to count hours, fight for sleep, work, or feel dread. It can then cue alertness. A plan may ask you to go to bed when sleepy within the schedule. It may ask you to change activity or place when awake and upset. There is no public clock rule here.

“Leave the bed” may be wrong for some people. Examples include fall risk, pain, limited mobility, a medical bed, infant care, or no safe second room. A clinician can change the posture, activity, light, or place while keeping the treatment goal.

What the evidence says changed

The clearest evidence is for the whole package. The 2021 AASM review found 124 eligible studies and pooled 89. Response was 45 percentage points more common with CBT-I than with controls. Remission was 33 points more common. Certainty was low to moderate. Definitions, packages, and controls varied.4

Diaries also improved. On average, people fell asleep about 13 minutes sooner and spent about 19 fewer minutes awake later in the night. A smaller study set found about 40 fewer minutes of total wake time. Not every result met the AASM threshold for clinical importance.4

A 2015 review of 20 face-to-face trials found larger diary changes against inactive controls. Sleep onset was about 19 minutes shorter. Wake time later in the night was about 26 minutes shorter. Sleep efficiency was about 10 percentage points higher. Total sleep was only about 8 minutes longer, with no clear difference.5 The trials excluded many major health and sleep conditions.

That is why the title of this draft says more consolidated sleep, not more total sleep. In the broad AASM review, total sleep time did not show a clinically meaningful overall diary gain after CBT-I. Actigraphy, a movement-based device measure, showed less total sleep time in the CBT-I groups than in controls in the pooled analysis.4

This does not mean people imagined improvement. Diaries and devices answer different questions. A diary records the sleep you felt and recall. Actigraphy estimates sleep from movement. Polysomnography measures brain, breathing, and body signals. Insomnia is partly defined by lived sleep trouble and daytime effect. Self-report matters even when a person knows the treatment. A device is useful too, but neither measure is the whole truth.

A 2024 network review covered 241 trials with more than 31,000 adults. Better remission was linked with cognitive work, time-in-bed restriction, stimulus control, and some newer methods. Sleep hygiene added no clear remission gain in that model.6 The model assumes components add up and trials can be compared. Hidden links could change the answer. It does not prove one perfect recipe.

What the first days and weeks may feel like

There is no reliable rule that CBT-I gets worse for exactly two weeks before it works. Some people notice improvement early. Some have uneven nights. Some feel sleepier, more tired, irritable, or less sharp after time in bed is reduced. Studies did not collect harms in a consistent enough way to give a precise rate or promise an exact end date.4 900683-9)

One difficult fourth night is not a verdict. The useful questions are broader:

• Track whether wakefulness in bed changes across the week.
• Rate your alertness while driving, working, or caring for someone.
• Note any change in mood.
• Check whether the plan is possible in your home and schedule.
• Ask whether the burden is reasonable enough to continue.

The HABIT trial enrolled 642 adults in U.K. primary care. They got brief nurse-led restriction or a sleep-hygiene booklet. At six months, insomnia scores were about three points lower with restriction. Gains lasted through 12 months. Serious events were equal and not judged treatment-related. Some people still reported tiredness and driving concern. Eleven percent assigned to restriction stopped because it was too hard or did not help.900683-9) The sample was mostly White. Some diary and device data were missing. Benefit and burden can exist together.

Longer follow-up is encouraging. A meta-analysis of 30 controlled trials found benefits for insomnia severity, sleep onset, and sleep efficiency at 3, 6, and 12 months. Effects became smaller over time.8 A relapse plan may help you respond early when illness, travel, stress, or caregiving disrupts sleep. It cannot guarantee that insomnia will never return.

Who this evidence fits, and who needs a different start

The evidence best fits adults with chronic insomnia who have a real chance to sleep. Many studies included common health conditions. Some key trials still excluded unstable illness, untreated sleep disorders, bipolar disorder, substance problems, or night work.

CBT-I may still be useful when depression, anxiety, pain, or treated sleep apnea is present. Those conditions also need their own care. The plan needs closer review when any of these apply:

• You fall asleep without warning, are very sleepy in the day, or have had a driving near miss.
• You snore loudly, stop breathing, gasp, or wake with severe headaches.
• You have cataplexy, sleep attacks, restless legs, sleepwalking, or dangerous nighttime behavior.
• You have bipolar disorder, new reduced need for sleep, rising energy, racing thoughts, impulsive behavior, or psychosis.
• You have epilepsy, especially if seizures are not well controlled.
• You have falls, nocturia, mobility limits, sedating medicines, or no safe way to move at night.
• You are pregnant, recovering after birth, or responsible for overnight infant or dependent care.
• Your job involves driving, machinery, heights, weapons, long shifts, or other safety-sensitive work.
• Alcohol, cannabis, opioids, stimulants, another substance, or medication changes may be affecting sleep.
• You are in a suicidal crisis or another mental-health condition is getting worse fast.

These are not automatic lifetime bans on CBT-I. They are reasons to adapt a component, monitor more closely, refer, delay, or treat another problem first.3 4

Your job and your family’s job

Direct trials of partner or family involvement are sparse. This family guidance is a practical clinical inference, not a proven CBT-I component. It should be consent-based and revocable.

What to do this week

Do preparation, not a do-it-yourself restriction plan.

Observable target: Record the pattern between getting into bed, estimated sleep, getting out of bed, and daytime function.

Short baseline: Use 7 to 14 days if you can. This is a practical span, not a diagnostic cutoff.

Choose one to three actions:

1. Complete a brief morning sleep record.
2. Note one daytime result, such as alertness while driving, fatigue at work, mood, or a nap.
3. Make a list of medicines, over-the-counter products, caffeine, alcohol, cannabis, and other substances to bring to a clinician.

Use paper or a phone note for a few minutes each morning. A clinician should review the pattern. On a low-capacity day, record when you got up, total sleep, and driving safety. If you miss a day, restart the next morning. Do not fill in a week from memory.

At review, decide whether to continue observation, simplify it, adapt the plan, evaluate another cause, or begin formal CBT-I. Do not calculate your own sleep window from this article.

Words you can use

• Patient: “I want to try CBT-I, but my job involves driving. How will we protect alertness and adjust the plan if I get too sleepy?”
• Partner or family member: “Would it help if I handled the early drive this week, or would you prefer a different kind of support?”
• Clinician: “Can we review whether this is chronic insomnia, what else could be affecting sleep, and whether restriction or gradual compression is safer for me?”
• On night four: “This is one night, not a grade. I will follow the agreed plan only if I can do it safely, record what happened, and contact the clinician if sleepiness or mood becomes unsafe.”

How to measure real-life progress

Do not let one wearable score decide whether treatment works. Review several lanes:

• Sleep continuity: less time awake in bed, fewer long wake periods, and a more stable pattern.
• Insomnia burden: less dread, frustration, or distress about sleep.
• Daytime function: alertness, fatigue, concentration, work, caregiving, and quality of life.
• Safety: no drowsy driving, near misses, falls, seizures, or dangerous mood activation.
• Treatment burden: whether the plan is realistic in your job, home, body, and family.
• Durability: whether gains hold during stress and whether a brief reset or booster is needed.

A plan can improve insomnia severity without adding total sleep time. It can also improve a diary more than actigraphy. Those are not interchangeable outcomes.

Access at three levels

Start today: Keep the short baseline and write one functional goal, such as “stay alert for my commute” or “spend less time awake and frustrated in bed.” This costs no money and does not require changing your sleep window.

Lower-cost support: Ask clinics, health systems, insurers, community centers, or employee programs about groups, telehealth, or supported digital care. The VA’s CBT-i Coach is made for use with a provider. Insomnia Coach is a self-care education tool and does not replace care.15 Check current eligibility, privacy, language, internet needs, and support.

Formal care: Search the Society of Behavioral Sleep Medicine directory or ask for a trained clinician.14 Ask what CBT-I parts are included, who reviews the diary, how safety is checked, and how the plan can fit work, disability, pain, housing, or caregiving.

No directory listing is an endorsement. Availability, insurance, licensure, and telehealth geography must be checked directly.

A simple coordination plan

Write one goal, baseline dates, the strategy, and the owner of each task. Set a review date for sleep, function, burden, and safety. Share only what the plan needs. Family receives details with patient consent, unless immediate safety duties require action.

Escalation criteria should be specific to the person. Examples include unsafe sleepiness, a near miss, a fall, seizure change, new unusual energy, worsening depression, inability to follow the plan safely, or signs of another sleep disorder. The clinician can then continue, simplify, compress more gradually, pause, refer, or choose another treatment.

Safety: when to get more help

What remains uncertain

We need better data on early side effects, driving, falls, burden, and gradual compression. Many trials did not represent unstable bipolar illness, uncontrolled seizures, severe sleepiness, pregnancy, postpartum care, shift work, unsafe housing, or complex disability. Race, income, language, and rural access were often poorly reported.

We also do not know the best format for each person. Therapist support may improve fit but can be hard to reach. Digital care may widen access and still lack key content or safety checks.

CBT-I does not promise perfect sleep. It offers a structured chance for more continuous sleep, less distress, and better days. That is strong enough without a promise of more hours asleep.

Frequently asked questions

Does CBT-I mean I will be told to sleep less?

Not exactly. One component may temporarily reduce planned time in bed so it better matches current sleep. The aim is less wakefulness in bed and better continuity, not sleep loss for its own sake. A clinician should choose and review the plan. Total sleep may change little or fall at first.

How soon should CBT-I work?

There is no fixed schedule. Some people notice change in the first weeks. Others improve more slowly or need an adaptation. One bad night cannot show success or failure. Review the weekly pattern, daytime function, burden, and safety.

Is sleep hygiene the same as CBT-I?

No. Sleep hygiene covers supportive habits and the sleep setting. CBT-I combines behavioral and cognitive treatment, monitoring, review, and relapse planning. The AASM suggests against sleep hygiene as the only treatment for chronic insomnia.2

Can I do CBT-I with an app?

Some guided digital programs have evidence, and self-care tools may help with education or tracking. Programs differ in content, support, privacy, and safety review. A generic app is not automatically full CBT-I or equal to trained care. People with safety concerns or complex conditions should involve a clinician.

When should I pause and call the clinician?

Call when sleepiness makes driving or work unsafe, or after a near miss or fall. Call if seizures change, mood shifts sharply, you sleep much less without feeling tired, or the plan no longer fits. Do not push through a warning to prove commitment.

If you or someone else is in immediate danger, call 911. For suicidal crisis or emotional distress in the United States, call or text 988 or use the 988 Lifeline chat.

This article is for education and is not a diagnosis or an individual treatment plan. Sleep problems can have more than one cause. A qualified clinician can help you choose care that fits your health, medicines, schedule, and safety needs. Do not start, stop, taper, or change a prescription medicine based on this article.

Tools you can use

CBT-I is and is not

A two-week expectation guide

This guide describes what to notice. It does not predict what must happen on a fixed day.

Sleep-diary starter

Complete this soon after waking. Estimates are acceptable. Do not watch the clock all night to make the record exact.

Date:
Got into bed:
Tried to sleep:
Best estimate of time to fall asleep:
Best estimate of total awake time after first falling asleep:
Final wake time:
Got out of bed:
Best estimate of total sleep:
Naps:
Medicines or substances that may affect sleep:
Morning sleep quality, in my own words:
Daytime alertness or fatigue:
Driving, work, fall, seizure, mood, or other safety note:
One barrier or helpful condition:

Minimum version: record final wake time, best estimate of total sleep, and whether you felt safe for driving or required duties.

Before-you-start safety and access checklist

Check any item to discuss before a clinician reduces time in bed:

• I have unintended sleep episodes or severe daytime sleepiness.
• I drive long distances or work with machinery, heights, weapons, patients, or other high-stakes duties.
• I snore loudly, gasp, stop breathing, or wake with severe morning headaches.
• I have cataplexy, sleep attacks, restless legs, sleepwalking, or another unusual nighttime event.
• I have bipolar disorder, recent reduced need for sleep, unusual energy, racing thoughts, impulsivity, or psychosis.
• I have epilepsy or recent seizure change.
• I have falls, nocturia, frailty, mobility limits, or no safe route out of bed.
• I am pregnant, recovering after birth, or responsible for overnight care.
• Pain, disability, a medical bed, shared housing, or caregiving makes standard rules hard to follow.
• I use sleep medicine, opioids, alcohol, cannabis, stimulants, or another sleep-altering substance.
• I work nights or rotating shifts.
• Depression, suicidal thoughts, mania, psychosis, substance use, or another condition is worsening quickly.
• I need language, vision, hearing, reading, memory, internet, transportation, or cost accommodations.

Checking a box does not ban CBT-I. It tells the clinician where the plan may need adaptation, monitoring, referral, or delay.

Weekly progress dashboard

Do not use one wearable score as the summary grade.

Partner or family support card

Ask first: “Would you like me involved this week? If so, what would be useful?”

Helpful options:

• Help with a ride, a morning task, childcare, or another agreed duty.
• Support the agreed schedule without enforcing it.
• Keep the chosen safe, dim activity available for awake periods.
• Ask about alertness and support needs instead of demanding a sleep score.
• Name a near miss, fall, seizure, unusual energy, or severe mood change and help contact care.

Avoid:

• Judging effort from one night.
• Repeating “Did you sleep?” every morning if it adds pressure.
• Hiding, adding, sharing, or changing medicine.
• Urging the person to push through unsafe driving or work.
• Taking over the diary or becoming the therapist.

Family involvement is voluntary unless immediate safety requires emergency action.

Night four script bank

Patient to self: “Night four is one data point. I do not have to prove this plan by ignoring danger.”

Patient to support person: “Please ask whether I need a ride or help today, not whether I passed last night.”

Support person: “I will help with the plan you chose. A near miss, fall, seizure, or unusual mood change is a reason to call, not a reason to try harder.”

Patient to clinician: “The last four nights were uneven. Here is my diary, daytime function, and safety record. Should we continue, simplify, compress more gradually, or reassess?”

Questions for a CBT-I provider

1. How do you confirm chronic insomnia and screen for other sleep disorders?
2. What training do you have in CBT-I or behavioral sleep medicine?
3. Which components are included, and how do you decide what to adapt?
4. Who selects and reviews the sleep window?
5. How often will we review daytime alertness, driving, falls, mood, seizures, and burden?
6. How do you adapt stimulus control for pain, disability, nocturia, caregiving, or shared housing?
7. How will you coordinate with my prescriber or other clinicians?
8. What should I do if work or caregiving makes the plan unsafe?
9. Is this individual, group, telehealth, guided digital, or another format?
10. What privacy, language, technology, insurance, and geographic limits apply?
11. What counts as a fair trial, and what happens if it does not help?
12. What is the relapse or booster plan?

Access ladder

Troubleshooting table

Copy-ready coordination sheet

My functional goal:
Baseline dates:
Pattern we are treating:
Other conditions we are evaluating or treating:
Strategy chosen:
Patient-owned task:
Clinician-owned task:
Family task, if the patient consents:
How often we review:
Review date:
Information I consent to share:
Prompt-call signs:
Emergency plan:
If burden is too high, we will consider: continue, simplify, gradual compression, pause, referral, or another treatment.

Related reading

• The Harder You Try, the Further It Gets
• You’re Not Weak. It May Be Rebound
• He Can’t Fall Asleep. It May Not Be Defiance
• Sleep Was the First Thing to Change
• Sleep Medications Demystified
• Sleep Studies Explained

References

1. Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD. Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2016;165(2):125-133. doi: 10.7326/M15-2175. PMID: 27136449. 2. Edinger JD, Arnedt JT, Bertisch SM, et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2021;17(2):255-262. doi: 10.5664/jcsm.8986. PMID: 33164742. Full text. 3. Department of Veterans Affairs and Department of Defense. VA/DoD Clinical Practice Guideline for the Management of Chronic Insomnia Disorder and Obstructive Sleep Apnea. Version 3.0. 2025. Official guideline page. Full guideline PDF. 4. Edinger JD, Arnedt JT, Bertisch SM, et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2021;17(2):263-298. doi: 10.5664/jcsm.8988. PMID: 33164741. PMCID: PMC7853211. 5. Trauer JM, Qian MY, Doyle JS, Rajaratnam SMW, Cunnington D. Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis. Ann Intern Med. 2015;163(3):191-204. doi: 10.7326/M14-2841. PMID: 26054060. 6. Furukawa Y, Sakata M, Yamamoto R, et al. Components and Delivery Formats of Cognitive Behavioral Therapy for Chronic Insomnia in Adults: A Systematic Review and Component Network Meta-Analysis. JAMA Psychiatry. 2024;81(4):357-365. doi: 10.1001/jamapsychiatry.2023.5060. PMID: 38231522. PMCID: PMC10794978. 7. Jernelöv S, Rosén A, Forsell E, Blom K, et al. Is sleep compression therapy non-inferior to sleep restriction therapy? A single-blind randomized controlled non-inferiority trial comparing sleep compression therapy to sleep restriction therapy as treatment for insomnia. Sleep. 2025;48(8):zsaf093. doi: 10.1093/sleep/zsaf093. PMID: 40205789. Registration: NCT02743338. 8. van der Zweerde T, Bisdounis L, Kyle SD, Lancee J, van Straten A. Cognitive behavioral therapy for insomnia: A meta-analysis of long-term effects in controlled studies. Sleep Med Rev. 2019;48:101208. doi: 10.1016/j.smrv.2019.08.002. PMID: 31491656. 9. Kyle SD, Siriwardena AN, Espie CA, 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. Lancet. 2023;402(10406):975-987. doi: 10.1016/S0140-6736(23)00683-9. PMID: 37573859. NIHR trial report. 10. Buysse DJ, Martin JL, Burgess HJ, et al. Combination treatment for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2026;22:56. doi: 10.1007/s44470-025-00038-8. PMID: 41975142. 11. Buysse DJ, Arnedt JT, Buenaver L, Chang JL, Fernandez-Mendoza J, et al. Combination treatment for chronic insomnia disorder in adults: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2026;22:58. doi: 10.1007/s44470-025-00039-7. PMID: 41986788. Full text. 12. National Highway Traffic Safety Administration. Drowsy Driving: Avoid Falling Asleep Behind the Wheel. Accessed August 31, 2026. Official page. 13. 988 Suicide & Crisis Lifeline. Contact Us. Accessed August 31, 2026. Official page. 14. Society of Behavioral Sleep Medicine. United States Member Directory. Accessed August 31, 2026. Directory. See also the AASM provider-finding page. 15. U.S. Department of Veterans Affairs. CBT-i Coach and Insomnia Coach. Accessed August 31, 2026. CBT-i Coach. Insomnia Coach.

If you or someone you know is in crisis

• Call 911 or go to your nearest emergency room for any life-threatening emergency.
• 988 Suicide & Crisis Lifeline — call or text 988, available 24/7. En español: marque 988 y oprima 2. Veterans: 988 and press 1, or text 838255.
• Crisis Text Line — text HOME to 741741.
• The Trevor Project (crisis support for LGBTQ+ young people) — call 1-866-488-7386, or text START to 678-678.
• National Sexual Assault Hotline (RAINN) — call 1-800-656-HOPE (4673) or text HOPE to 64673; free, confidential, 24/7. Online chat at RAINN.org/hotline.
• National Domestic Violence Hotline — call 1-800-799-SAFE (7233) or text START to 88788; 24/7, help in 200+ languages. Online chat at TheHotline.org. If your phone or computer may be monitored, calling from a safer device is an option.
• Riverside County — Inland SoCal Crisis Helpline 951-686-HELP (4357), 24/7 (Inland SoCal United Way / 211+, in partnership with RUHS-BH); Community Access, Referral, Evaluation and Support (CARES) Line 800-499-3008, 24/7.
• San Bernardino County — Access Unit (Behavioral Health Helpline) 888-743-1478, 24/7; Mobile Crisis/CCRT 800-398-0018 (24/7, all ages) or text 909-420-0560. Arrowhead Regional Medical Center (ARMC) has a dedicated walk-in adolescent psychiatric ER (ages 13–17).
• Children under 13 — call 911 for immediate danger, contact your county's mobile crisis team (they respond to all ages), or go to the nearest pediatric emergency room.
• California Peer-Run Warm Line (non-crisis — someone to talk to) — call or text 1-855-600-WARM (9276); daytime and evening hours, not a 24/7 line.
• NP Fady (non-emergency) — for routine scheduling or questions, call (909) 707-6261. This line is not monitored for emergencies.