A Summary of the Main Components the Ten CBT-I Strategies
(1) Regulate your circadian rhythm
Maintain a regular bedtime and rise time every day of the week.
Limit light exposure in the evening and at night.
Get plenty of light exposure during the day, especially soon after awakening.
Consider taking timed low-dose melatonin.
Systematic sleep scheduling may be needed (see Strategy 9)
(2) Build enough sleep drive to sleep
Maintain a regular bedtime and rise time every day of the week.
Avoid napping, or take one nap per day of less than 20 minutes (use an alarm).
Engage in physical exercise (but not in the hour before bed).
Limit caffeine intake and avoid caffeine during the 6 hours before bedtime.
Systematic sleep scheduling may be needed (see Strategy 9)
(3) Re-associate your sleep environment with sleep
Use your bed only for sleep (sex is ok).
Go to bed only when you are sleepy (and not just merely fatigued).
Get out of bed if you are unable to fall asleep within 20 minutes. Go to another room and engage in quiet non-stimulating activities. Return to bed only when sleepy. Try not to fall asleep elsewhere. Repeat this step as many times as necessary throughout the night.
Do not remain in bed if you are feeling anxious or frustrated.
(4) Refrain from engaging in sleep effort and practice acceptance
(5) Reduce psychological and physical tension
Schedule a time to deal with your worries well before bedtime.
Allow for a “wind down” period before bedtime in which you engage in calming activities.
Learn relaxation and mindfulness meditation techniques to calm the mind and body.
(6) Optimize your sleep environment
(7) Avoid substances that disrupt sleep
(8) Address use of sleep medications (if applicable)
(9) Improve sleep efficiency using systematic sleep scheduling
Deliberately stay up later to accumulate sleep drive to improve your sleep quality.
As your sleep efficiency improves, gradually move your bedtime earlier to increase your sleep quantity.
(10) Modify unhelpful sleep-related beliefs
Learn more about sleep, insomnia, and CBT-I.
Consider the evidence for and against a belief.
Try new behaviors to see if the belief is necessarily true.