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Adult sleep-restriction therapy plan

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Sleep restriction therapy: the 2-week plan.

The most evidence-backed component of CBT-I. Compress your time in bed to match your actual sleep, then expand it back as efficiency climbs. Single page, no app needed.

What this is:the core behavioural arm of CBT-I, the first-line treatment for chronic insomnia per the AASM and NICE. It feels worse before it feels better — sleep deprivation in week 1 is the mechanism. Stick the full 14 days or don’t start.

Step 1 — Baseline (do this BEFORE day 1)

Average sleep time

From a 7-day sleep diary, average the actual hours slept (NOT time in bed). Most insomniacs land at 5.5-6.5h despite spending 8h+ in bed.

Avg sleep: ____ h ____ min

Prescribed time in bed

Average sleep + 30 min (never below 5h total). This is your window for week 1. Set your wake time first (consistency is non-negotiable), then count backwards.

Wake: ____ : ____
Bed: ____ : ____
Window: ____ h ____ min

Step 2 — Week 1 log

Day	Bed time	Wake time	Sleep efficiency
M	____	06:30	____ %
T	____	06:30	____ %
W	____	06:30	____ %
T	____	06:30	____ %
F	____	06:30	____ %
S	____	06:30	____ %
S	____	06:30	____ %

Sleep efficiency =(hours actually asleep ÷ hours in bed) × 100. Your phone’s built-in sleep app or a basic wearable is sufficient — exact precision doesn’t matter, the trend does.

Step 3 — Weekly adjustment rule

Average efficiency (week)	Adjustment for next week	Why
≥ 90%	Move bedtime 15 min earlier. Wake time stays.	Sleep is consolidated. Add capacity.
85-89%	No change. Repeat the same window.	System is converging. Hold.
< 85%	Move bedtime 15 min later. Compress further.	Window still too wide. Need more sleep pressure.

Non-negotiable rules

1. No naps. Anywhere. Even 5 min counts.
2. Wake time fixed every day, including weekends.
3. Out of bed within 20 min if not asleep — read in dim light, return when sleepy.
4. Bed only for sleep + sex. No phone, no TV, no work.
5. No clock-watching. Turn it away.

When to stop / call a clinician

Daytime sleepiness so severe you can’t drive safely.
Mood swings, mania symptoms, or active suicidal thoughts.
4 weeks in, efficiency still < 80%.
Witnessed apnea / gasping during sleep — get a sleep study before continuing.
Pregnancy — modified protocol needed, see a CBT-I therapist.

What “working” looks like: by end of week 2, sleep latency drops from 30+ min to under 15 min. By week 4, total sleep typically increases by 60-90 min on a smaller window. Effects last 6-12 months in 70-80% of completers (Trauer et al., Annals of Internal Medicine, 2015).