Cognitive Behavioral Therapy for Insomnia

A practice card

Not a single trick. A structured program with a few established parts, limiting time in bed, tying the bed back to sleep, examining thoughts about sleep, usually run with a clinician's guidance.

When

When poor sleep has lasted for weeks and habit changes tried alone haven't moved it.

What's actually happening

The program works on a few fronts at once: limiting time in bed to match actual sleep tends to build pressure to sleep; using the bed only for sleep re-links it with rest instead of wakeful effort; and examining anxious thoughts about sleep, like the fear of a bad night, tends to lower the anxiety that keeps sleep away. The parts tend to work better combined than any one alone.

What to change

Keep a simple record of when you actually sleep across some nights, before changing anything.

Ask a clinician about sleep restriction, deliberately shortening time in bed, since it needs guidance to do safely.

Stop reading, working, or scrolling in bed, so the bed stays linked with sleep and nothing else.

Notice thoughts like 'I'll never manage tomorrow without sleep now' and ask whether that's held true before.

Leave the bed if sleep isn't coming, and return only once sleepy, rather than lying there working at it.

Where to start

roughly placed · tracking comes before changing anything

Pick one

Five at once is how these lists fail. Tap a number — the ones up and to the left give the most for the least.

What to expect

This is a program usually run over several weeks, guided by someone trained in it, not a single habit tried alone overnight. Sleep restriction needs a clinician; the bed-only habit can be practiced alone for two weeks before judging whether sleep comes easier.

choose one, and the fortnight starts

This is a teaching, not treatment. If you’re struggling, a doctor or therapist can help. If you’re in danger right now, call your local emergency number or a crisis line (in the US, call or text 988).