Table 7.

Common Components of Cognitive-Behavioral Treatment for Insomnia

Sleep restriction therapy205	Sleep restriction seeks to relieve insomnia by improving sleep efficiency (SE). Patients are instructed to reduce their time in bed to slightly above their total sleep time. Once patients have achieved 90% SE (i.e., 90% of time in bed is spent asleep), time in bed is systematically increased.
Stimulus control206	Stimulus control seeks to restrict bedroom activity to sleep and sex. Patients are also instructed to decrease the impact of potential environmental distractions, for example, by wearing earplugs to reduce ambient noise.
Cognitive therapy207	Cognitive therapy for insomnia seeks to correct erroneous beliefs and worry regarding the amount of sleep one requires and the potential consequences of poor sleep.
Relaxation or mindfulness208,209	Relaxation has an extensive empirical basis as an effective intervention for numerous psychophysiological and stress-related disorders. More recent efforts have included mindfulness in insomnia protocols, as an alternate strategy to reduce physiologic hyperarousal and cognitive rumination.
Sleep hygiene	Sleep hygiene seeks to eliminate sleep-interfering behaviors such as excessive or poorly-timed caffeine consumption.