Behavioral sleep medicine practitioners and other experts share the biggest hurdles patients face in CBT-I and offer their tried-and-true tricks for keeping them committed to therapy. Skip ahead to:Mismatched expectations | Sleep diaries | Sleep restriction | Six rules of stimulus controlTop CBT-I Challenges for Insomnia Patients and Strategies to Overcome ThemThe problem: Mismatched expectationsPatients sometimes enter CBT-I without a clear understanding of what it entails. Of course, these are good things to do, but CBT-I is really a systematic and tailored behavioral treatment. According to Wang, “Without ongoing motivation and support, patients may lose interest or fail to fully engage with the therapeutic activities.” 0388 Why do patients drop-out from cognitive behavioral therapy for insomnia (CBT-I)?