English-speaking therapist in Berlin-Pankow CBT for insomnia and sleep problems

We all sleep badly now and then, for example before an exam, after an argument or during a difficult time. It usually settles by itself. For some people, though, poor sleep persists long after the trigger has passed. Specialists then speak of insomnia, meaning difficulty falling or staying asleep. Around 6 to 10 in 100 adults are affected. Perhaps some of this sounds familiar:

Poor sleep counts as insomnia when nights like these happen several times a week, last for weeks or months and affect you during the day. There is no fixed number of hours below which sleep is too little.

Many people then try to catch up on sleep: they go to bed earlier, stay in bed longer in the morning or nap at midday. That is understandable, but it often unsettles the sleep rhythm even more. On top of this comes the worry about the next bad night, and that worry itself keeps you awake. This can easily turn into a vicious circle.

This page is about insomnia. Other sleep disorders, such as sleep apnoea with pauses in breathing or narcolepsy, are diagnosed and treated by doctors.

If thoughts of not wanting to live come to you during sleepless nights, please take them seriously. You can get immediate help around the clock: see In an acute crisis.

CBT-I is a form of cognitive behavioural therapy developed specifically for sleep problems. It targets what keeps poor sleep going: habits around bedtime, an irregular rhythm and thoughts that will not settle at night. Four to eight sessions are usual, at first mostly a week apart. Between sessions, you put what we have discussed into practice at home. This is especially important in CBT-I.

I am a licensed psychological psychotherapist (CBT) and have worked in sleep research.

The first weeks with a fixed sleep window are demanding. Many people feel more tired during the day than usual, and some find it harder to concentrate or feel more irritable. This is a known effect of the treatment and is usually temporary. We discuss beforehand how to plan for this period, and I regularly ask how alert you feel during the day.

If you feel very sleepy during the day, please do not drive and do not operate dangerous machinery. If you drive for work or work in a job where tiredness could be dangerous, we adapt the approach.

With some conditions, lack of sleep can trigger or worsen symptoms, for example with epilepsy or bipolar disorder. In that case, we do not use sleep restriction, or only in a milder form, in agreement with your doctor. So please tell me in the first session which conditions you have and which medication you take.

Poor sleep can also have a physical cause. At the start of therapy, a check-up with your GP is therefore advisable. It is particularly important if any of the following applies to you:

Please do not stop prescribed medication on your own. If you have a physical illness, CBT-I is still possible. The illness is then treated alongside it.

A night in a sleep laboratory is usually not needed to diagnose insomnia. It is mainly useful if another sleep disorder is suspected. Your doctor decides on this.

If you work shifts or your sleep rhythm has shifted a lot, we talk about it in the first session. The usual CBT-I approach then needs to be adapted.

Poor sleep rarely comes alone. With depression, sleep is usually disturbed. With anxiety disorders, worry and tension keep you awake, and with constant stress at work, your thoughts often circle around your job at night too. Conversely, ongoing insomnia can increase the risk of later developing depression or an anxiety disorder.

If poor sleep is the main issue, we often start with CBT-I. The guideline also recommends it when depression or an anxiety disorder is present as well. In studies, depressive symptoms often improved too. If, on the other hand, depression or an anxiety disorder is the main focus, we mainly treat that. Elements of CBT-I can then be included. You can find more on my pages about depression and burnout and about anxiety and panic.

The professional standard in Germany is the S3 clinical guideline on insomnia in adults (2025 update). It recommends CBT-I as the first treatment for everyone affected, including when a physical or mental illness is present as well. The 2023 European insomnia guideline also recommends CBT-I as the first treatment.

In studies, many people sleep considerably better after CBT-I. The improvement often lasts beyond the end of treatment. Not everyone's symptoms disappear completely. That is why we regularly review your progress together using the sleep diary.

According to the guideline, sleeping pills are an option if CBT-I does not help enough or is not possible, and then usually only for a short time. Some of them can lead to dependence if taken for longer. The guidelines do not recommend over-the-counter sleep aids from the antihistamine group or herbal remedies. Only doctors can prescribe medication. I offer CBT-I.

Both guidelines also consider digital CBT-I programmes. The German guideline, however, prefers CBT-I delivered face to face, that is, in direct contact with a therapist.

A session lasts 50 minutes and usually costs €151.55. I bill under the official German fee schedule for psychotherapists (GOP). The fee is exempt from VAT and may vary depending on the work involved. We discuss at the start how many sessions you are likely to need, so that you can estimate the costs.

Mine is a private practice for privately insured patients, people entitled to Beihilfe (the medical allowance for civil servants) and self-paying patients. You receive an invoice from me. Whether and how much your private health insurer or Beihilfe reimburses depends on your diagnosis, your policy and the rules that apply to you. It is best to ask them before you start whether you need to apply and whether a report from a doctor is required.

If you have statutory health insurance (gesetzliche Krankenversicherung), cost reimbursement (Kostenerstattung) by your health insurer may be an option. You apply before treatment starts. In that case, please do not book an appointment yet, but email me first. I support you with the application, and your insurer makes the decision. I explain how it works on my page about fees and reimbursement. There you will also find my checklist and an application template.