Cognitive restructuring

Identifying negative or self-defeating thinking that contributes to insomnia, challenging its accuracy, and replacing it with more adaptive or realistic thoughts, which reduces the affectual response. An individual can then use self-talk, distraction, or rationalization to replace the negative thoughts with more positive ones.

Dealing with worries before bedtime

An individual keeps a journal where they can write down thoughts that they cannot get out of their head. They then literally sign off on the journal for the evening, telling themselves that they will come back to it the following day but not during the night.

Stimulus control

Setting a consistent sleep-wake cycle and waking time, avoiding or reducing naps, using the bed only for sleep and sexual contacts, and leaving the bedroom when unable to fall sleep, returning when feeling sleepy.

Sleep restriction

Reducing the time spent in bed when not asleep. The goal should be to spend 85% to 90% of time in bed asleep.

Relaxation training

This can involve techniques that reduce stress arisen during the day and stress from worrying about not being able to sleep. During a planned relaxation period before bed, specific relaxation therapies to be tried include:

– Progressive muscle relaxation

– Meditation

– Imagery

– Self-hypnosis

– Diaphragmatic breathing

– Mindfulness

– Biofeedback