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After Week 4 of Sleep Therapy, it is recommended that one should check to see if they are now free from insomnia. One can do this by looking at the same things in their current sleep diary, before they started Sleep Therapy. This chapter provides suggestions to find out the experiences of initial insomnia, multiple awakenings, middle insomnia, and terminal insomnia. If a person takes longer than 30 minutes to fall asleep, he/she is experiencing “initial insomnia”. If a person has more than 3 awakenings per night, he/she can describe it as having “multiple awakenings”. If a person awakes each night, (3 nights or more) for greater than 30 minutes, he/she is experiencing “middle insomnia”. If a person wakes up for more than 30 minutes too early on at least 3 mornings, then he/she has “terminal” or “end-of-night” insomnia.
Sleep Therapy is the term used for the specific program, which combines the most powerful and effective components of cognitive behavioral therapy for insomnia. The first part of the program, called FIRST THINGS FIRST, involves recording one’s sleep using sleep diaries to assess the nature of their insomnia. This chapter focuses on how to uncover, or rediscover, the biological processes that allow one to sleep. It shows how to tailor one’s bedtime and rise time in order to get solid sleep, and how to associate one’s bed with great sleep. The procedures will be summarized in Six Steps to Solid Sleep, the main techniques of Sleep Therapy. With some practice of these relaxation and “cognitive therapy” techniques, one knows how to move their mind into a state that is more conducive to having sleep arrive, to having the velvet hammer descend.
This chapter guides one forward after the third week of sleep therapy. It presents a chart called Calculating Your Week 3 Sleep Efficiency. By entering the sleep diary answers for Questions 1 to 7 in the top section of the chart one can calculate the sleep efficiency. The chapter also presents Six Steps to Solid Sleep for week 4: go to bed only when sleepy and not before your threshold bedtime; maintain a regular threshold rise time in the morning; use the bed only for sleeping; leave the bed if one can’t fall asleep or go back to sleep within 10–15 minutes, return when sleepy, and repeat this step as often as necessary during the night; if sleepiness is overwhelming, one may take a short nap (set aside no longer than 45 minutes) in the afternoon, between 1:00 and 4:00 p.m; and maintain a sleep diary.
This chapter guides one forward after the first week of sleep therapy. It presents a chart called Calculating Your Week 1 Sleep Efficiency. By entering the Sleep Diary answers to Questions 1 to 7 for one’s typical night into this chart one can calculate the sleep efficiency for Week 1 of Sleep Therapy. If at any point one realizes that the night chosen is not really representative of the week, then one can try another night and see how close the sleep efficiencies are. If the nights are not consistent, then one may want to calculate all 7 sleep efficiencies and take the average for the week. The chapter also presents a chart that helps to adjust one’s threshold bedtime, and Six Steps to Solid Sleep.
This chapter explains two essential elements form Sleep Therapy, which are based on sleep science and psychology principles. Many people find this background intriguing. What’s more, it is always easier to carry out techniques when one understands how they work. The elements of Sleep Therapy are: uncovering one’s natural sleep processes and associating one’s bed with sleep. By understanding how sleep comes and goes in the natural state one can see more clearly how to restore healthy sleep. Good sleep comes when our biological sleep processes can operate without interference. Associating one’s bed with sleep element of Sleep Therapy is based on something called “conditioning” or “learned associations”. These are connections one make in their mind (automatically) between two things that occur together on several occasions.
This chapter summarizes the strategies of sleep therapy in 6 specific steps. The steps of sleep therapy appear to be simple, but they require some time and effort. The most important factor that determines whether their sleep will improve is the consistency with which one follows the steps. The chapter discusses fifth and sixth steps. Fifth step is if sleepiness is overwhelming, one may take a short nap (set aside no longer than 45 minutes) in the afternoon, between 1:00 and 4:00 p.m. Many programs recommend that one avoid daytime naps entirely because naps may make it harder to sleep at night. While this is partially true, one also knows that humans are biologically predisposed to have a nap in the afternoon if circumstances permit. Sixth step is maintaining a sleep diary. Keeping a sleep diary will show how one’s sleep improves as a result of their actions.
This chapter comes up with two numbers that are essential for Sleep Therapy. Sleep Therapy combines the most effective components of Cognitive Behavioral Therapy for Insomnia (
CBT-I); it involves tailoring bedtime and rise time for sleep needs, and associating bed with great sleep. Knowing the numbers will allow one to tailor their sleep improvement procedures. The first number is one’s “total sleep time”, which is how much sleep they are getting now. The second number is “sleep efficiency”, which is how solid their sleep is. One can use their baseline sleep diary to estimate fairly accurately their baseline values for total sleep time and sleep efficiency. The chapter shows how to estimate one’s baseline sleep duration, based on a night from their sleep diary.