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Skills Classes

Behavioral Medicine, Chronic Illness, and Integrated Primary Care

Skills Class 6 - Optimizing CBT-I in Medically Complex Patients: Considerations (and Reassuring Successes) for Stimulus Control and Sleep Restriction

Thursday, June 25, 2026
4:00 PM - 5:30 PM PDT
Location: Yerba Buena Salon 2, B3 Level
Earn 1.5 Credit
Keywords: Treatment, Sleep, Health Psychology
Level of Familiarity: Moderate to Advanced
Recommended Readings: Scott AJ, Correa AB, Bisby MA, et al. Cognitive Behavioral Therapy for Insomnia in People With Chronic Disease: A Systematic Review and Meta-Analysis. JAMA Intern Med. 2025;185(11):1350–1361.,   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.,   Krista M Greeley, Joshua Rash, Joshua Tulk, Josée Savard, Melanie Seal, Robin Urquhart, John Thoms, Kara Laing, Emily Fawcett, Sheila N Garland, Impact and mechanisms of cognitive behavioral therapy for insomnia on fatigue among cancer survivors: a secondary analysis of a randomized controlled trial, Sleep, Volume 48, Issue 6, June 2025, zsaf014, https://doi.org/10.1093/sleep/zsaf014,   ,  

    Author(s)

  • KS

    Kelsey Sewell, Ph.D.

    Associate Professor
    University of Kansas Medical Center
    Shawnee, Kansas, United States

    • Co-Author(s)

  • Kadie Harry, Ph.D.

    Licensed Psychologist
    St. Luke's Health System
    Shawnee, Kansas, United States

Cognitive behavioral therapy for insomnia (CBT-I) is currently considered the gold standard treatment for those with chronic insomnia, with recommendations superseding pharmacotherapy. Research strongly supports this protocol in improving sleep quality, reducing sleep disruption, and consolidating sleep structure. Yet, there are large gaps in treatment availability, related to insufficient training opportunities, limited provider availability in many geographical regions, and discomfort with using the protocol in special populations, such as those with medical complexity. CBT-I protocols require thoughtful adaption to address medical comorbidities, symptom burden, and treatment constraints.

This skills-based class will provide clinicians with practical strategies for implementing stimulus control and sleep restriction in medically complex populations while maintaining safety, flexibility, and treatment efficacy. Presenters will draw on extensive experience of adapting this protocol for various settings, medical conditions, and barriers. In addition to discussing theoretically-driven modifications, presenters will review real CBT-I sleep data of patients in highly specialized populations, such as an older adult with Parkinson’s disease and a cancer patient in active treatment, to illustrate successful sleep consolidation.

This session is designed for clinicians with foundational knowledge of the core tenets of CBT-I, including psychoeducation, monitoring sleep data, stimulus control, and sleep restriction. Participants will leave with concrete tools they can immediately apply among complex medical patients across multiple treatment settings.

Learning Objectives:

  • Review literature on implementation of CBT-I in medical populations.
  • Identify theory-driven modifications to stimulus control and sleep restriction that increase accessibility for medically complex patients.
  • Apply theoretical discussion of modified clinical interventions to real world case examples and sleep data.