BC Doctors Are Calling for Better Insomnia Care. Here’s What That Means for You
In December 2025, two British Columbia psychiatrists went public with something that most insomnia sufferers in this province have suspected for years: the system is failing you.
Writing in the Victoria Times Colonist, Dr. Diane McIntosh — a psychiatrist and clinical assistant professor at UBC — and Dr. Tatiana Gregoryanz of Island Health made the case plainly: CBT-I is the recommended first-line treatment for chronic insomnia, but most BC patients can’t access it through public funding. The result, they argued, is that hundreds of thousands of British Columbians are left relying on medications that carry real risks — or managing on their own with approaches that don’t work.
If you’ve been bouncing between sleep hygiene advice and a prescription you’re not sure you should still be filling, that will sound familiar.
What the BC Psychiatrists Actually Said
The argument McIntosh and Gregoryanz made isn’t a fringe opinion. It aligns directly with clinical guidelines from the Canadian Sleep Society and the American College of Physicians, both of which place CBT-I above medication as the first treatment to try for chronic insomnia.
Their concern is the gap between what the guidelines say and what BC patients actually receive. Without publicly funded access to CBT-I, the fallback is benzodiazepines and Z-drugs — medications like lorazepam and zopiclone that carry documented risks including daytime sedation, dependence, and falls, particularly in older adults. Many frustrated patients end up self-medicating with alcohol, cannabis, or over-the-counter aids instead. None of these address why the insomnia started or why it persists.
The problem isn’t a lack of awareness among sleep specialists. The problem is a system that funds the less effective option and leaves the more effective one largely inaccessible.
Why Is CBT-I So Hard to Find in BC?
Part of the answer is structural. PharmaCare covers medications. It doesn’t cover therapy. A GP who wants to help a patient with insomnia can write a prescription in the same appointment — referring to a CBT-I provider requires knowing one exists and navigating a separate system entirely.
A study published in the Canadian Journal of Medicine found that 98% of primary care providers treating insomnia patients review sleep hygiene with them first. Only 58% discuss CBT-I. That’s not because GPs don’t care — it’s because sleep hygiene is fast to explain, familiar, and costs nothing to recommend. CBT-I requires a trained provider, multiple sessions, and a patient who knows to ask for it.
Most people don’t know to ask. And even those who do often hit dead ends: waitlists, providers who don’t take new clients, or services that aren’t available in their region of BC.
What CBT-I Actually Is
CBT-I is a structured, evidence-based treatment that addresses the thoughts and behaviours that keep insomnia going. It typically runs four to eight sessions and works by rebuilding your relationship with sleep — not by sedating you. The core techniques include sleep restriction, stimulus control, and cognitive work targeting the 3 a.m. thought spirals that most people with chronic insomnia know well.
Unlike sleep hygiene (which has minimal evidence for chronic insomnia in adults) or medication (which stops working when you stop taking it), CBT-I produces durable changes. The improvements tend to hold after treatment ends.
For a full breakdown of how it works and what to expect, see our complete guide to CBT-I.
You Don’t Have to Wait for the System to Catch Up
McIntosh and Gregoryanz are right that BC needs better public access to CBT-I. That change will take time — policy always does.
What doesn’t require a policy change: accessing CBT-I now, without a referral, virtually, wherever you are in British Columbia.
BC CBT-I offers individual CBT-I delivered virtually across the province. Sessions are provided by a Registered Clinical Counsellor (RCC) and member of BCACC. No waitlist, no GP referral required. Extended health plans that cover RCC services will typically cover sessions — it’s worth checking your benefits before you assume you’re paying out of pocket.
If you’ve been sitting with chronic insomnia while waiting for the system to offer you something better, you don’t have to keep waiting.
Book a free consultation to get started.
Frequently Asked Questions
Is CBT-I covered by BC extended health benefits?
Many BC extended health plans cover services provided by a Registered Clinical Counsellor (RCC). Coverage amounts and limits vary by plan, so it’s worth checking your policy directly. Unlike publicly funded options, private CBT-I through an RCC is available without a referral and without a waitlist. If your plan covers RCC services, it will typically apply to CBT-I sessions.
Do I need a doctor’s referral to access CBT-I in BC?
No. You can self-refer to a registered CBT-I provider in BC without a GP referral. If you’re using extended health benefits, check whether your plan requires a physician referral for reimbursement — most RCC-based plans do not. You can book directly and begin within days rather than waiting for a referral pathway that may not move quickly.
If you’re ready to stop waiting and start sleeping, reach out here. Virtual sessions are available to residents across British Columbia.
