CBT-I Session 3 Summary


This is a summary of the module CBT-I 3 for your reference.

The Insomnia Cycle

This diagram shows you the relationship between unhelpful thoughts, emotions, or behaviors. This vicious cycle of insomnia can begin with unhelpful thoughts, which can have a negative impact on your emotions and behaviors. The goal is to stop the cycle. 


Take a moment to write down some unhelpful thoughts, emotions, or behaviors you notice as you're trying to fall asleep.



Conditioned Arousal

Conditioned arousal is learning that occurs unconsciously and results from repeatedly pairing the bed with wakefulness. It develops when you consistently feel negative emotions such as frustration, anxiety, worry, and tension when you’re unable to sleep. Over time, automatically, going to bed = negative emotions.


Stimulus Control

With insomnia, it is common to feel tired before bed, but feel awake in bed. Stimulus control teaches you how to break the association between bed and arousal.

Stimulus control involves avoiding sleep incompatible behaviors before bed (exception: sexual activity). Sleep incompatible behaviors create associations between the bed and being awake.

Stimulus control also teaches you how to develop a positive relationship between your pre-sleep rituals, sleep environment, and falling asleep. 


Which of the following unhelpful sleep behaviors are a part of your bedtime routine today?

__ Watch TV

__ Work or study

__ Search the internet

__ Check social media

__ Talk on the phone

__ Text messaging

__ Eat or drink (except water)

__ None of the above


Do you find yourself struggling to stay up when relaxing on the sofa in the living room?

1. Yes

2. No

3. Sometimes


When you go to bed, do you become wide awake?

1. Yes

2. No

3. Sometimes


What are some of the things you do when you find yourself wide awake in bed?



Tips to Stop Conditioned Arousal

  • Go to bed only when sleepy (not just fatigued or tired).

  • Use the bed and bedroom only for sleep (and sex).

  • If unable to sleep after 20 minutes, get out of bed and return to bed only when sleepy.

  • Wake up at the same time every day regardless of how much you slept.

  • Limit napping or if unavoidable, only nap for a short time - i.e 10 minutes or so.


Here are some suggested activities to help you wind down in the evening. Select those you'd like to try.

__ Choose your outfit for the next day

__ Prepare for lunch or dinner for the next day

__ Take a bath or long shower 

__ Surf the internet (non-stressful topics only, and don't forget to use your blue light blocking glasses!)

__ Watch a movie or show (not action films)

__ Take your dog for a long walk

__ Listen to slow, relaxing or instrumental music

__ Catch up on laundry

__ Write in your journal

__ Do some stretches


Here are some suggested activities if you find yourself awake in the middle of the night.

__ Catch up on reading

__ Call friends or family on other time zones

__ Make grocery shopping list

__ Create list of enjoyable weekend activities

__ Write down thoughts to decrease thinking and worrying

__ Do crafts until you're sleepy


Here are some suggested activities if you find yourself awake before your scheduled wake time.

__ Meditate or pray

__ Watch the sunrise

__ Take your dog for a walk

__ Read the news

__ Work out

__ Send emails to friends

__ Make the bed or tidy up bedroom

__ Open curtains and blinds in the house

__ Water houseplants or do light gardening

__ Review your to-do list for the day or week


Here are some suggested activities for enjoying your morning.

__ Take a shower

__ Make a special breakfast

__ Have your favorite coffee or tea

__ Go for a walk

__ Schedule a visit with a friend

__ Relax in a comfy chair