CBT-I Session 4 Summary

CBT-I 4

This is a summary of the module CBT-I 4 for your reference.

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What is Sleep Restriction Therapy (SRT)?

SRT is a gradual, multi-step process designed to improve sleep quality by decreasing wakefulness after sleep onset. 

The aim of SRT is to condition the body to sleep during a fixed amount of time without lying in bed awake or napping, ultimately reducing unwanted wakefulness and improving sleep quality.

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How do I implement SRT?

  • Step 1: Reduce the Time in Bed (TIB) to the time you are currently able to sleep.

  • Step 2: Choose a wake-up time that fits your lifestyle and circadian tendencies.

  • Step 3: Expand Time in Bed (TIB).

We’ll explore each step in further detail.

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Step 1. Reduce Time in Bed (TIB)

TIB = Average total sleep time in the past week

Because sleep patterns vary over the course of the week in people with insomnia, it is important to track your sleep behavior for all 7 days of the previous week by filling out daily sleep diaries (found on the Homepage of your Goodpath app).

After filling out 7 days of data, reach out to your coach to review your average TIB and discuss recommendations.

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Step 2. Choose wake time

Now that you have determined your TIB, you have to choose a wake time that fits your lifestyle and circadian tendencies.

This allows your bedtime to naturally follow. Count back from your selected wake time (i.e. if TIB is 6 hours and you need to wake up at 6:30am for work, then your bedtime would be 6 hours before your wake time, or 12:30am).

Wake time tips

  • It is recommended that you get out of bed 5 to 10 minutes after wake time.

  • Wake time should be the same, even on non-work days.

  • For this to be effective, consistency is important.

  • Continue to implement what you learned with stimulus control.

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How are you feeling about limiting your time in bed?

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It’s okay if you find this challenging. Try a modification to make the process feel more manageable.

SRT Modification 1

Your initial TIB is larger than your average total sleep time in the past week; this means that you add 15-30 minutes to your total sleep time.

This will account for the time to fall asleep and brief nocturnal arousals, which are normal.

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SRT Modification 2

Sleep compression therapy includes gradually restricting TIB, rather than abrupt restriction. 

For example, if your current TIB is 8 hours and your average total sleep time is 6 hours, then you would gradually reduce your TIB to 6 hours on a weekly basis, reducing it by 20 minutes at a time.

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Step 3. Expand Time in Bed (TIB)

Once you are sleeping better in the night and feeling tired in the day, you can begin to gradually increase your TIB.

You can do this by moving back your bedtime by adding 15 minutes every week.

When you reach your ideal bedtime, you will notice that you are sleeping better in the night and feeling rested in the day.