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BACKGROUND: Insomnia is prevalent among patients with heart failure (HF) and is associated with reduced physical and mental functioning, including possible exacerbation of cognitive deficits. OBJECTIVES: This study evaluated the effects of Brief Behavioral Treatment for Insomnia (BBTI) on insomnia and related factors among HF patients. METHODS: Twenty-three HF patients with insomnia (70% women; 65% white; Mage = 55.7 ± 11.3 years; NYHA Class II = 70%) were randomized to a behavioral intervention (BI; n = 12) or sleep monitoring (SM; n = 11) group. Sleep, cognitive functioning, quality of life, distress, self-care, and functional status were assessed pre- and post-intervention. RESULTS: BI participants experienced reduced insomnia and increased sleep quality and efficiency, with 58% demonstrating clinically meaningful improvements in insomnia and 25% achieving remission of insomnia symptoms. Depression and anxiety also improved in BI participants. CONCLUSIONS: BBTI was tolerated well within this symptom-limited patient population and was associated with reduced symptoms of insomnia and distress.