Sleep restriction is a core CBT-I technique that consolidates sleep by reducing time in bed to actual sleep time. It seems counterintuitive, but generates homeostatic pressure that makes sleep deeper and more continuous. Sleep efficiency improves first, and the time-in-bed window is gradually expanded.
Concept origin
Spielman, Saskin, and Thorpy (1987) developed the technique as part of the 3P model. It is the most active component of CBT-I: recent meta-analyses show large effect sizes (d > 0.8) for sleep efficiency, comparable to or better than long-term pharmacotherapy.
Therapeutic approach
Average actual sleep time (not time in bed) is calculated and a time-in-bed window equal to that time is set, with a minimum of 5 hours. When sleep efficiency exceeds 85% for one week, the window is extended by 15-30 minutes. The process repeats until optimal duration is reached.
Related concepts
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