If you typically struggle to fall asleep or fall back asleep after waking then this is a step you can consider as it is an integral part of restructuring your sleep patterns.

If you believe you do not have any sleep issues then simply bypass this lesson.

Please note: if you would like to track your current sleep habits, you can do so with the sleep tracker found below in the resource section (you will not find it inside the workbook).

Bedtime Restriction Therapy

Sleep restriction builds sleep pressure by limiting the time you spend in bed. Over time, your brain relearns to associate the bed with sleep only, leading to faster sleep onset, fewer awakenings, and deeper sleep. While the initial stages may be challenging, the gradual increase in sleep efficiency ensures long-term improvements. This approach rewires your brain to protect and prioritize sleep.

Sleep efficiency—calculated as the percentage of time spent asleep versus time in bed—is a key measure used to guide adjustments in bedtime schedules. If your sleep efficiency is low, then bedtime restriction therapy limits your time in bed to better align it with actual sleep time, gradually improving sleep quality and reducing insomnia over time.

It involves limiting the time you spend in bed initially, based on your actual sleep, to rebuild healthy sleep pressure. The goal is to increase both your sleep drive - the ability to fall asleep and sleep efficiency—the percentage of time you spend asleep while in bed—so you sleep more deeply and restore better habits.

It is the most powerful of the techniques used in CBTi as it helps to retrain our sleep system and in the process increasing our sleep confidence AND decreasing our sleep anxiety!

Bedtime Restriction Therapy is Good For:

Those who struggle to fall asleep (more than 15 minutes of trying)
Those who feel 'tired and wired' (feeling tired but cannot shut down the brain or the anxiety)
Those who are in bed for 8 hours but are only getting about 4 (for example) hours of quality sleep
Those who have multiple wakings at night time and find it difficult to fall back asleep

Bedtime Restriction Therapy Might Not Be Good For:

Those with sleep disorders such as narcolepsy or hypersomulence conditions. Other parts of CBTi can be helpful with these conditions (working with the anxiety and challenging thoughts). I would encourage you to talk to your Doctor if they think that CBTi would be helpful in these instances. It is also my hope that in working towards desensitizing the nervous system and brain that this might have an impact on the degree of hypersomulence you experience.

What to expect:

Changing sleep habits takes time and patience. For us to rewire the brain towards a better night's sleep we need to make some changes to not only our beliefs but also our sleep behaviors.

Important - Please Note...

If you choose to give sleep restriction a 'go', please know that it will be challenging up front. You will be tired and so we need to plan ahead of time so to avoid driving or other tasks that could be dangerous while sleepy. This should only be applicable in the first 2 - 3 days of trying out sleep restriction therapy. Please use your judgement as to if you deem it to be safe to undertake any activity while sleepy in the first few days of sleep restriction therapy. Ideally, you should begin to notice changes to your sleep patterns after about 1 - 2 weeks.

Step #1 - Getting prepared:

a) Complete the 'Sleep Diary Tracker' everyday for 2 weeks. Be sure to print off two copies (one for each week). You will find the links to the instructions and worksheets below (worksheets and calculator provided by Sleepwell.ca. Sleepwell.ca is a free resource for patients and clinicians to help with CBTi).

b) Calculate your sleep numbers by visiting the second resource listed below titled 'Sleep Efficiency Calculator'

Step # 2 - Getting clear on go to bed time and waking time

c) Set your 'go to bed' time: Once you have your sleep efficiency percent/number then you can follow these guidelines:

As a general rule, if the average sleep efficiency is 85% or more, then the time in bed is extended. If it is below 85% then the time is bed is further restricted.

If your sleep efficiency number is below...

Less than 85% - set your go to bed time to 15 minutes later
Less than 80% - set your go to bed time to 30 minutes later
Less than 70% - set your go to bed time to 1 hour later
Less than 60% - set your go to bed time to 1.5 hours later

So, if your usual go to bed time is 10:00 pm and your sleep efficiency percentage is 68% then your new go to bed time is 11:30 pm. Stick to this time every day for at least 2 weeks. It will be difficult for the first couple of days but it will get easier.

d) Set your waking time - based on your daily schedule, set a time to wake up consistently every day. Consistency is important here!

e) Avoid taking naps - you will feel really tired in the early stages of this process but it is really important to avoid naps even if you are really tired. If you take a nap it will negate the sleep drive work that we are doing to get a better nights sleep. If you are feeling very sleepy during the day then rather than taking a nap, get outside, go for a short walk, call a friend, get crafty...whatever it takes to keep you awake.

Step #3 - At the end of each week

a) Calculate efficiency number - use your sleep efficiency calculator to calculate your efficiency number again based on a typical nights sleep and then adjust accordingly.

Once your sleep efficiency is up above 85 - 90% then you can start to add back in time to your sleep. Here are the guidelines:

If your sleep efficiency is 80% - 85% or above you can add 15 minutes to your sleep time (ie go to bed 15 minutes earlier)
Once your sleep efficiency score is 90% then you can add another 30 mins
Above 90% you can add back in 45 minutes to an hour to your sleep time

Building Your Sleep Drive

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