CBT-i as first choice – pharmacotherapy as secondary intervention

Sleep disorders are often associated with pronounced daytime sleepiness, difficulty concentrating and increased feelings of stress. Diagnosis is generally based on the clinical history; if necessary, an actigraphy or polysomnigraphy can also be informative. Cognitive behavioral therapy (CBT-i) is recommended as a first-line treatment for chronic insomnia in both the current European guidelines and the German guideline updated in 2025. Digital tools can support treatment. If medication is used, there are a few things to bear in mind.