CBT-I

Cognitive behavioral therapy for insomnia combines a sleep diary, a sleep window, stimulus control, cognitive work and education, usually over 4–8 sessions. MoSleep delivers these principles as small daily steps. It is not therapy and does not replace a clinician.

Evidence: Strong: recommended first for long-term insomnia by major guidelines.

Sources: American College of Physicians, 2016 — CBT-I as initial treatment for chronic insomnia; American Academy of Sleep Medicine, 2021 — behavioral treatments guideline

Why bed can mean "awake"

When many nights are spent awake and frustrated in bed, the brain can learn to link bed with alertness. Spending less time awake in bed helps unlearn the link.

Evidence: Well established in sleep research.

Sources: Bootzin, 1972 — stimulus control; American Academy of Sleep Medicine, 2021 — behavioral treatments guideline (reference being verified)

Stimulus control

Go to bed when sleepy, use bed only for sleep (and intimacy), get up when wound up, and keep a fixed wake time. Together these retrain the bed–sleep link.

Evidence: Conditional recommendation as a stand-alone; strong as part of CBT-I.

Sources: American Academy of Sleep Medicine, 2021 — behavioral treatments guideline; Bootzin, 1972 (reference being verified)

Sleep window (sleep restriction & compression)

Matching time in bed to the sleep you actually get builds sleep pressure, so sleep becomes deeper and steadier. MoSleep uses a gentle version (compression) by default, never below 5.5 hours, and widens it as sleep improves.

Evidence: Conditional recommendation as a stand-alone; core part of CBT-I. Gentler compression has less research.

Sources: American Academy of Sleep Medicine, 2021 — behavioral treatments guideline

Harder before easier

When starting CBT-I, daytime sleepiness can rise for a week or two before sleep improves. That is why the window can always be widened or paused, and why drowsy driving warnings are always shown.

Evidence: Reported in clinical commentary on the guidelines.

Sources: Psychiatric News, 2016

The sleep diary

A short daily log of when you went to bed, fell asleep and got up. It shows patterns a single night hides, and shapes your sleep window.

Evidence: Standard practice in CBT-I.

Sources: American Academy of Sleep Medicine, 2021 — behavioral treatments guideline

A fixed wake time

Your body clock is set largely by when you get up and see light. A consistent wake time, weekends too, steadies when sleepiness arrives at night.

Evidence: Standard part of CBT-I.

Sources: American Academy of Sleep Medicine, 2021 — behavioral treatments guideline

Mind Drift (imagery distraction)

Picturing simple, neutral images can crowd out worry before sleep. It is a gentle distraction, not a sleep switch.

Evidence: Small studies; promising but limited.

Sources: Harvey & Payne, 2002 — imagery distraction (reference being verified)

Park It (to-do offloading)

Writing a specific to-do list before bed may help you fall asleep sooner than writing about what you already did.

Evidence: One small study in healthy young adults.

Sources: Scullin et al., 2018, Baylor University

Worry Window & problem-solving

Giving worries a set time earlier in the day, and turning problems into next steps, may reduce how aroused your mind is at bedtime.

Evidence: Moderate; part of cognitive approaches to insomnia.

Sources: Frontiers in Psychology, 2011 — cognitive control and insomnia

Problem vs worry

A problem has a next step; a worry loops. Sorting them lets you act on one and set the other down.

Evidence: Moderate; structured problem-solving may lower pre-sleep arousal.

Sources: Frontiers in Psychology, 2011

Let It Pass (defusion)

From acceptance and commitment therapy: noticing a thought as a thought ("I'm noticing the thought that…") can loosen its grip, instead of arguing with it.

Evidence: Growing evidence for ACT-based approaches to insomnia; less than for CBT-I.

Sources: ACT-based approaches for insomnia (review) (reference being verified)

Permission to Rest (paradoxical intention)

Trying hard to sleep keeps you awake. Letting go of the effort, and aiming only to rest, often lets sleep arrive.

Evidence: Conditional; part of the CBT-I toolkit.

Sources: American Academy of Sleep Medicine, 2021 — behavioral treatments guideline

Breathe (relaxation)

Slow breathing at around 5–6 breaths a minute can calm the body. Relaxation is one component of CBT-I.

Evidence: Conditional as a stand-alone; helpful as part of a program.

Sources: American Academy of Sleep Medicine, 2021 — behavioral treatments guideline

Rough-night reality check

At night, worries can feel like facts. Checking them gently ("what would I tell a friend?") is a core cognitive technique.

Evidence: Part of CBT-I.

Sources: American Academy of Sleep Medicine, 2021 — behavioral treatments guideline

The clock trap

Checking the time in the night tends to raise worry and effort to sleep. Turning clocks away is a simple fix.

Evidence: Small studies; widely used in CBT-I.

Sources: Clock-monitoring studies (to verify) (reference being verified)

Rethinking sleep beliefs

Beliefs like "I need 8 hours" or "one bad night ruins tomorrow" add pressure. Softening them is part of CBT-I.

Evidence: Part of CBT-I.

Sources: American Academy of Sleep Medicine, 2021 — behavioral treatments guideline

How sleep trouble keeps going

Sleep trouble often starts with a trigger, then is kept going by habits formed while coping: more time in bed, naps, clock-checking. The Reset targets those habits.

Evidence: A widely used model (Spielman's 3P model).

Sources: Spielman, 1987 — 3P model (reference being verified)

Keeping it

Rough nights still happen. Having a plan (anchor, Sleepy Check, getting up when wound up) helps a bad night stay a night.

Evidence: Standard final part of CBT-I.

Sources: American Academy of Sleep Medicine, 2021 — behavioral treatments guideline

Sleep hygiene

Caffeine, alcohol, light and the bedroom matter, but on their own they are not enough for long-term sleep trouble. That is why they appear only as side notes.

Evidence: Guidelines advise against sleep hygiene as a single therapy.

Sources: American Academy of Sleep Medicine, 2021 — behavioral treatments guideline

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