- LIMIT TIME LYING AWAKE
This section can be helpful with the falling asleep Step D1 and with interrupted sleep from Step D3.
This is a behavioral solution to the problem of lying awake in bed, regardless of the time of night. The general idea is to increase the association of bed with sleep and decrease the association of bed with anything else (except possibly sex, which often leads to sleep and is more difficult to do elsewhere).
Whenever the person is lying awake for more than a pre-determined amount of time, he/she should get up.
- It could be 15 minutes, as a rough estimate, or…
- When he/she becomes aware of being unable to sleep, or
- When he/she becomes frustrated about not going to sleep.
The person should leave the bedroom, go somewhere else and do something that is likely to encourage sleep. It could be relaxation, meditation, reading, watching a silly late night television program, etc. In any case, moving slowly is a part of the process, so the person is less likely to be energized than if moving rapidly.
The person should return to bed when ready.
- It could be a predetermined amount of time – possibly, a half-hour or hour.
- Or until he/she is sleepy.
This should be used in conjunction with restrictions – not to take compensating naps during the day (Section 32), and to go to sleep and get up at times chosen prior to beginning the approach (Section 25).
The approach is credited to Richard Bootzin. Helpful presentations can be found in Bootzin and Perlis (2011) and Bootzin etal (2010, pp.268-276). Brief but clear presentations also appear in Glovinsky and Spielman (2006, pp.154-155 and 176-178)