Contents

Introduction

The Sweet Spot

Who Can Benefit from This Book

How to Use This Book

Part 1: Laying a Foundation

Chapter 1: Taking a Look at Your Sleep

Effectiveness as Your Compass

Sleep Log

Common Questions (and Answers) or Roadblocks (and Possible Solutions)

Are You Willing to Start the Sleep Log?

Should You Have an Overnight Sleep Study?

Do You Have a Circadian Rhythm Disorder?

What Is Insomnia Costing You?

Your Next Step

Chapter 2: How Sleep Works

The Physiology of Sleep

Your Sleep Drive

Your Internal Body Clock

A Well-Choreographed Dance

How You Influence Your Sleep Physiology

Your Next Step

Chapter 3: The Insomnia Spiral

How People Get Stuck

A Case Example: How George Got Stuck

A Balancing Act

Stopping the Spiral

Chapter 4: Willingness: The Opposite of Struggle

Willingness as a Tool for Sleep

Willingness to Make Changes That Are Uncomfortable

The Value of Emotional Discomfort

Willingness to Not Sleep

Acceptance Is Not Resignation

Recognize How You Struggle with Sleep

Your Willingness Plan

Chapter 5: Create Your Own Individualized Treatment Plan

Is Insomnia the Right Place to Start?

Your Insomnia Snapshot

Your Insomnia Treatment Program

Choosing a Behavioral Treatment Program

Alternative Routes for Your Next Step

Choosing Cognitive Treatment Strategies

What to Do About Medications or Herbal Remedies That You Take for Sleep

Your Next Step

Part 2: Behavioral Strategies

Chapter 6: Retrain Your Brain (Stimulus Control Therapy)

Who Should Use Stimulus Control Therapy?

Stimulus Control Therapy: Detailed Instructions

Common Questions (and Answers) or Roadblocks (and Possible Solutions)

What to Expect

Your Stimulus Control Therapy Plan

Your Next Step

How to Evaluate Your Progress and When to Consider a Different Plan

Chapter 7: Quality Over Quantity (Sleep Restriction Therapy)

Who Should Use Sleep Restriction Therapy?

Sleep Restriction Therapy: Detailed Instructions

Common Questions (and Answers) or Roadblocks (and Possible Solutions)

What to Expect

Your Sleep Restriction Therapy Plan

Your Next Step

How to Evaluate Your Progress and When to Consider a Different Plan

Chapter 8: Combining Stimulus Control and Sleep Restriction

Who Should Use Combined SCT-SRT?

Combined SCT-SRT: Detailed Instructions

Your Combined SCT-SRT Plan

Your Next Step

Chapter 9: Sleep Hygiene

Sleep Hygiene Guidelines

Maintain a consistent sleep schedule.

Have a brisk wakeup, and get natural light within one hour of waking.

Eliminate or limit napping.

Eliminate or limit your stimulant intake.

Avoid activating medications at night.

Limit your use of alcohol and do not drink within three hours of bedtime.

Go to bed neither too hungry nor too full.

Exercise regularly, but not right before bed.

Engage in a wind-down routine.

Dim ambient lighting in the hour before bedtime.

Turn off electronic devices an hour before bedtime.

Sleep on a comfortable bed.

Create a comfortable bedroom environment.

Limit disruptions from your bed partners.

How to Make Hard Changes

Be Flexible

Increase Willingness

Have Realistic Expectations

Base Decisions on Data

Make a Plan

Your Sleep Hygiene Plan

Summary of Part 2: Behavioral Strategies

Part 3: Cognitive Strategies

Chapter 10: Changing What You Think (Cognitive Restructuring)

Who Should Use Cognitive Restructuring?

Negative Cognitions

Cognitive Distortions

Unhelpful Cognitions

Cognitive Restructuring

Example: George’s Cognitive Restructuring

Challenging Common Cognitive Distortions About Sleep

How Cognitive Restructuring Can Go Awry

Common Questions (and Answers)

Your Cognitive Restructuring Plan

What to Expect

How to Evaluate Your Progress and When to Consider a Different Strategy

Your Next Step

Chapter 11: Changing When and Where You Think (Designated Worry Time)

Who Should Use Designated Worry Time?

Designated Worry Time for Chronic Worriers

Designated Worry Time for Insomnia

How to Use Designated Worry Time

Common Questions (and Answers)

Your Designated Worry Time Plan

How to Evaluate Your Progress and When to Consider a Different Strategy

Your Next Step

Chapter 12: Accepting Your Thoughts (Mindfulness and Cognitive Defusion)

Who Should Use Mindfulness and Cognitive Defusion?

Mental Fitness

Mental Fitness and Sleep

Mindfulness

Mindfulness Exercises

Summary of Mindfulness Exercises

Cognitive Defusion

Cognitive Defusion Exercises

Example: George’s Use of Mindfulness and Defusion

How Mindfulness and Cognitive Defusion Go Awry

Common Obstacles (and Possible Solutions)

Your Mindfulness and Cognitive Defusion Plan

What to Expect

How to Evaluate Your Progress

Your Next Step

Summary of Part 3: COGNITIVE STRATEGIES

Part 4: Reviewing Your Progress and Maintaining Your Gains

Chapter 13: How Effective Is Your Program?

Taking Stock

How Are You Sleeping?

How Do You Feel During the Day?

Have You Found Your Sweet Spot?

How Closely Have You Followed Your Treatment Program?

Have You Used Effectiveness as Your Compass?

The Next Leg of Your Adventure

Common Questions (and Answers) About Planning the Next Leg of Your Adventure

Your Next Step

Chapter 14: Maintaining Gains Across Contexts

Transitioning from Your Sleep Program

Decide What to Keep in Place

Change One Element at a Time

Use Your Sleep Log

Anticipate Triggers for Sleep Disruption

Responding to Lapses and Relapses

Remember: Sleep to Live, Don’t Live to Sleep

Your Next Step

Chapter 15: Last Words

Acknowledgments

Appendix A: Circadian Rhythm Disorders

Do You Have a Sleep Preference or a Sleep Problem?

Accommodating Your Body’s Natural Rhythm

Shifting Your Body’s Schedule

Behavioral Therapy

Moving Your Bedtime and Wake Time

Deliberate Timing of Your Activities

Routine as an Anchor

Sleep Hygiene

Light Therapy

Advanced Sleep Phase syndrome

Delayed Sleep Phase syndrome

Adding Light

Blocking Light

Melatonin

Chronotherapy

Summary

Appendix B: Insomnia and Menopause

Treat Your Hot Flashes

Treat Your Sleep Disturbance

Stimulus Control Therapy (SCT)

Hot Flash–Specific Sleep Hygiene

Acceptance-Based Strategies

Your Next Step

References