Awake in bed? Start the clock.

While the timer runs

If you fall asleep before it ends, good — stop the timer whenever you wake. If you are still awake when it ends, get out of bed and do something quiet and boring in dim light until you feel sleepy, then come back.

Lying in bed awake teaches your nervous system that bed is a place for frustration and wakefulness. Stimulus control breaks that link. Bootzin's 1972 protocol — still a core component of CBT-I — says to leave the bed when you cannot sleep and only return when sleepy, so the bed re-earns its association with falling asleep.

How to use it well

• Don't watch the clock. Start the timer, then turn it face-down or look away. Clock-watching feeds the arousal you are trying to settle.
• The exact number doesn't matter. Fifteen, twenty, twenty-five minutes — the point is to not lie there indefinitely. If unsure, leave it at 20.
• Get up fully. Sitting up against the headboard doesn't count — the bed needs to mean sleep. Move to a chair or another room.
• Repeat as often as needed. Getting up four times in one night is not failure; it is the protocol working. The association rebuilds over weeks.

Sources

• Bootzin RR (1972). Stimulus control treatment for insomnia. Proceedings of the American Psychological Association, 7, 395–396.
• Bootzin RR, Epstein DR (2011). Understanding and treating insomnia. Annual Review of Clinical Psychology, 7, 435–458.