Table 1.

Metacognitive Treatment Model for Insomnia

Elements of secondary arousal	Shift to adaptive stance	Reduction in secondary arousal
Attention and emotional bias towards sleep-seeking or sleep-aversive thoughts and behaviors	Balance	Allow the state of sleepiness to guide sleep-related behavior
Rigidity in sleep-related behaviors and beliefs	Flexibility	Adjusting intentionally to changing conditions
Attachment to sleep-related needs and expectations	Equanimity	Calmness stemming from non- striving and patience about sleep
Absorption in solving the sleep problem	Commitment to Values	Pursuit of valued living in the context of the range of thoughts and emotions