Scientifically Reviewed by
Dr. Elaine Blank, PhD
PhD in clinical psychology from the University of Arizona, Clinical internship at the University of Maryland,
Postdoctoral work at the Stanford University School of Medicine
If your sleep has been bad for a long time, two questions follow: is that typical, and does it still get better? Responses from more than 21,000 people who took the Rest sleep quiz answer the first. The research on Cognitive Behavioral Therapy for Insomnia (CBT-I) answers the second.
How Long Have Most People Been Struggling With Sleep Problems?
A long time. Of 21,694 quiz responses in 2025, about 78% had been dealing with sleep problems for a year or more, many for several years or their whole adult life.
By gender:
Women: 77.4% report sleep problems lasting a year or longer
Men: 81.6%
"Several years" was the most common answer for both, from 42.4% of women and 56.9% of men. Over 20% of women and 16.7% of men said "entire adult life."
Is There Hope for Long-Term Sleep Problem Recovery?
Yes. People with chronic insomnia, meaning sleep difficulty lasting three months or more, improve with CBT-I, and the improvement lasts [1].
Beaulieu-Bonneau and colleagues followed patients for 24 months after CBT-I. Time to fall asleep dropped by 11 to 19 minutes on average and stayed there; time awake during the night improved by 41 to 76 minutes depending on the treatment arm [1].
The timeline is shorter than most people expect. CBT-I is usually delivered over 6 to 10 weeks of weekly sessions, 70 to 80% of patients respond during treatment, and 50 to 60% of responders reach full remission within 6 to 12 months [2].
Years of bad nights and told to just try harder?
Rest helps you get your sleep back on track in 8 weeks, however long the problem has been there. Users who completed the program went from 75% to 88% sleep efficiency.
What Approaches Have People Already Tried Before Finding CBT-I?
Sleep medication, mostly, regardless of how long the problem has lasted. Among long-term sufferers (several years or entire adult life), 34.1% had tried sleep medication on its own, the single most common approach.
In the same group:
Combinations of medication with routine changes, staying in bed longer, or cutting caffeine: 52.4%
Non-medication approaches only (routine changes, caffeine, more time in bed): 9.6%
None of the above: 7.5%
Short-term sufferers (weeks to months) also reached for medication first: 70.9% had used it alone or in combination, and 10.6% had tried none of the listed approaches.
Do Gender Differences Matter for Treatment Success?
Somewhat. The same 24-month study looked at sex differences across treatment sequences [1]:
Women kept improving from 6 to 24 months on combined CBT-I plus medication
Men responded differently, and some combinations got worse over the same period
On CBT-I alone, men improved significantly from 6 to 24 months while women held steady
CBT-I works for both. The best sequence and timeline may differ, which is an argument for individual treatment planning.
Why Don't Quick Fixes Work for Chronic Sleep Problems?
Because they do not touch what keeps insomnia going. Respondents had tried medication, routine changes, more time in bed and less caffeine, often in combination, and were still struggling.
Sleep medication relieves symptoms but does not teach the skills that end the problem. In the long-term study, people who used medication "as needed" were more likely to be back on it at follow-up than those who completed a taper [1].
Staying in bed longer, one of the most common strategies in the quiz, makes insomnia worse: it widens the gap between the time you give sleep and the sleep you can actually produce. Sleep restriction therapy, part of CBT-I, exists to close that gap [2].
When Should You Consider Professional CBT-I Treatment?
Sooner than most people do. With more than three-quarters of respondents past the one-year mark, often after several failed approaches, earlier treatment would spare years.
Consider CBT-I if you have:
Sleep difficulties for 3 months or more (the threshold for chronic insomnia)
30 or more minutes to fall asleep, regularly
30 or more minutes awake during the night, regularly
Daytime impairment from poor sleep
A sleep medication you would like to reduce or stop
The American College of Physicians, the European Sleep Research Society and other major medical organizations recommend CBT-I as the first treatment for chronic insomnia [2].
Does the Duration of Sleep Problems Predict Recovery?
No. People who have had insomnia for decades improve with CBT-I. In a follow-up of up to 31 months, gains were maintained and total sleep time kept improving [1].
If you have been struggling for months or years, the quiz data says you are in the majority and the research says the length of the problem does not limit the recovery. Structured programs and CBT-I-based apps such as Rest are both routes in.
Citations
[1] Beaulieu-Bonneau et al., "Long-Term Maintenance of Therapeutic Gains Associated With Cognitive-Behavioral Therapy for Insomnia," Sleep (2017)
[2] Muench A, Vargas I, Grandner MA, Ellis JG, Posner D, Bastien CH, Drummond SP, Perlis ML. We know CBT-I works, now what? Fac Rev. 2022 Feb 1;11:4. doi: 10.12703/r/11-4. PMID: 35156100; PMCID: PMC8808745.
[3] Morin, C.M., & Espie, C.A. (2003). Insomnia: A Clinical Guide to Assessment and Treatment. New York: Springer Publishing.