Calculate and track sleep efficiency (time asleep ÷ time in bed × 100) — the key metric for CBT-I sleep restriction therapy.
Sleep efficiency is the percentage of time in bed that you actually spend asleep. A healthy sleeper has efficiency above 85%. People with insomnia often have low efficiency because they spend too long in bed awake. Tracking this weekly helps guide sleep restriction: when efficiency is consistently above 85%, you can extend your sleep window.
Use alongside the sleep diary during active CBT-I treatment, particularly when implementing sleep restriction. Helps both therapist and client track whether sleep efficiency is improving and whether the sleep window should be adjusted.
Explain sleep efficiency as the percentage of time in bed actually spent sleeping. Frame the target of 85-90% efficiency as the goal, and explain that the tracker will guide decisions about when to adjust the sleep window.
For clients who are numerically anxious, calculate sleep efficiency together in session rather than asking them to do it independently. For those who prefer visual tracking, use a graph format rather than a table.
Do not use sleep efficiency tracking in isolation from clinical judgment. Some clients become overly focused on the numbers, which can increase performance anxiety about sleep. If this occurs, reduce the frequency of calculation.
When sleep efficiency consistently exceeds 90% for one week, increase the sleep window by 15-20 minutes. When it drops below 85%, tighten the window. Never reduce the sleep window below 5 hours regardless of reported sleep time, as this risks excessive daytime sleepiness.
Suitable for clients working with insomnia, sleep efficiency, cbt-i, sleep restriction, sleep window. This tool can be used as a standalone worksheet or as part of a structured homework plan.
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The standard CBT-I sleep diary — record bed times, sleep times, wake times, and daytime functioning to track patterns and calculate sleep efficiency.
Identify and challenge dysfunctional beliefs about sleep that fuel insomnia-related anxiety and arousal.
A formulation based on Spielman's 3P model — mapping predisposing, precipitating, and perpetuating factors that maintain insomnia.
The core stimulus control rules for CBT-I — rebuilding the association between bed and sleep.