If insomnia patients had pillows handy, they’d probably use them to smack James Davig after he told them his usual pearl of wisdom about the cause of nightly sleeplessness.

“The most common problem with chronic insomnia,” he says, “is people spending too much time awake in the bed.”

Once you get past the head-slapping “duh” factor, the behavioral psychologist said, his statement really helps explain why people with chronic insomnia fail to get enough deep sleep. And he believes the solution is cognitive behavior therapy, which in many cases could replace the potent but sometimes problematic sleep medications that are widely prescribed.

“But they’ve got to be willing to put in the time — 7 to 9 appointments — and there’s homework to do,” said Davig, who sees patients at a sleep health center aligned with Regions Hospital in St. Paul. “It’s not just a warm bath and Barry Manilow music before bed.”

The cognitive approach requires, among other things, patients to keep detailed sleep journals that identify their periods of wakefulness at night and what they try to do to get back to sleep.

Davig said many patients try to overcome insomnia by spending more time in bed, but they typically don’t get more quality sleep in the process. And biding the longer awake time by surfing the Internet or watching TV makes matters worse.

“Anything they’re doing that makes them lay awake and alert in bed by definition is making insomnia worse,” he said.

Chronic insomnia is diagnosed when someone loses at least 30 minutes of sleep per night for three nights a week in a month.

Cognitive treatment has been around as long as medications, but Davig believes it will become more popular as research proves its worth.

An unpublished Regions study found that patients who completed the cognitive approach spent 67 percent less time awake in bed and increased their sleep from an average of 6.5 hours to 7 hours.

This “sleep efficiency” often results in deeper, more quality rest that is otherwise lacking for insomnia patients, Davig said. “We’re always working on getting better quality sleep.”