Host Katinka Blackford Newman speaks with sleep and insomnia expert Professor Colin Espie about why cognitive behavioral therapy for insomnia (CBT-I) is recommended as first-line treatment over medication. Espie explains how insomnia is perpetuated by frustration, threat-based arousal, and catastrophic thinking, and why sedative drugs don’t reproduce normal sleep, can lose effectiveness, carry dependency risks, and increase risks such as falls in later life. He outlines CBT techniques including cognitive restructuring, paradoxical intention, and the behavioral approach of sleep restriction therapy, citing research showing strong outcomes when delivered in primary care. Espie discusses Sleepio, his fully automated digital CBT program with a NICE guideline and NHS availability in Scotland, and points listeners to his book Overcoming Insomnia and resources from The Sleep Charity.

00:00 Welcome and Guest Intro

00:59 Colin’s Path to Sleep Science

01:46 Why CBT Beats Pills

03:19 The Insomnia Paradox

04:55 How Insomnia Becomes Chronic

07:43 Why Sleeping Pills Fall Short

11:20 Dependency and Long Term Risks

14:13 Stress Arousal and 4AM Panic

17:32 CBT Tools Cognitive Restructuring

21:24 Paradoxical Intention Explained

25:54 Sleep Hygiene Myths and Basics

28:40 Sleep Restriction Therapy

32:22 Medication Addiction and Access

35:28 Sleepio Digital CBT Program

37:39 Colin’s Own Sleep and Trusting Sleep

40:11 Resources and Closing