19 sources: 10 meta-analyses, 3 narrative reviews, 2 other designs, 1 randomised controlled trial, 3 systematic reviews
Physical · Practice
Reserve the Bed for Sleep
Using the bed mainly for sleep and getting up when awake and frustrated: stimulus control, a CBT-I component that Steinmetz 2024 and Verreault 2023 report effective for insomnia in component and network meta-analyses, with Verreault 2023 adding that results should be interpreted cautiously given study quality; on its own here as a habit, not as insomnia treatment.
as needed
Any levelHome
When to seek a professional
- Loud snoring with witnessed gasping/choking or breathing pauses plus daytime sleepiness (possible obstructive sleep apnea), refer to a clinician
- Difficulty falling or staying asleep at least 3 nights/week for 3+ months with daytime impairment (possible chronic insomnia disorder), refer to a clinician
- Excessive daytime sleepiness despite adequate time in bed, or falling asleep involuntarily during activities, refer to a clinician
- Persistent inability to sleep/wake at socially desired times despite good habits (possible circadian rhythm sleep-wake disorder), refer to a clinician
How to do it
Bed only for sleep; if awake ~20 min, get up and return when sleepy
The research behind this entry establishes something about dose, but not these exact parameters; treat them as a practical way to apply the finding rather than as the finding itself.
For most adultsStudentsParents
What the evidence says
What the sources say
This practice is one way to carry out what the sources on the concept entry (phys.sleep.concept.cbti-what-it-is) studied: cognitive behavioural therapy for insomnia and its components, stimulus control among them. Steinmetz 2024 (component network meta-analysis, 80 studies, 15,351 participants) reports that stimulus control improved total sleep time and names sleep restriction and stimulus control “the most effective components of CBT-I”. Verreault 2023 (network meta-analysis, 23 studies) reports stimulus control effective for improving insomnia compared with control conditions, with not all of its instructions appearing essential and results to be interpreted cautiously given study quality. Furukawa 2024 (component network meta-analysis, 241 trials) reports that sleep restriction and stimulus control improved both sleep quality and self-reported sleep continuity, and that these components may be beneficial. Morin 1994 (meta-analysis, 59 studies) reports psychological treatments effective and durable for chronic insomnia, with sleep hygiene education alone not effective. The sources evaluate stimulus control inside CBT-I, so anyone with persistent insomnia should see a clinician rather than assemble the therapy from habits. The full account, source by source, is on the concept entry this practice links to (phys.sleep.concept.cbti-what-it-is).
What we won't claim
- Do not claim to diagnose, treat, or cure insomnia, sleep apnea, or any sleep disorder
- Do not promise guaranteed, instant, or permanent improvements in sleep
- Do not present these general hygiene techniques as clinical therapy (e.g., CBT-I) or a substitute for medical care
- Do not present this as CBT-I or clinical insomnia treatment
19 sources: 10 meta-analyses, 3 narrative reviews, 2 other designs, 1 randomised controlled trial, 3 systematic reviews
- Agreement
- Direction recorded for 0 of 19 sources; not yet recorded for the rest.
- The claim's outcome
- Outcome not yet recorded
- Certainty
- No source states a certainty rating.
- Authors
- Sources share authors: C. Morin (first author of 2 sources).
What each source measured and concluded (19)
meta-analysis · 2021
Maurer et al. (2021) — The clinical effects of sleep restriction therapy for insomnia: A meta-analysis of randomised controlled trials.
- What it measured
- Self-reported insomnia severity (ISI) and sleep diary metrics at post-treatment
- How it was read
- screened only, not extracted
- What the review says it includes
- Meta-analysis of RCTs
- Studies and participants, as stated
- 8 RCTs
- Heterogeneity, as stated
- Sleep restriction therapy is efficacious for insomnia severity and sleep continuity, but results are limited by few comparisons, high risk of bias, and heterogeneity
meta-analysis · 2015
Koffel et al. (2015) — A meta-analysis of group cognitive behavioral therapy for insomnia.
- What it measured
- Qualitative and quantitative sleep outcomes (pre-post and follow-up)
- How it was read
- screened only, not extracted
- What the review says it includes
- Meta-analysis of RCTs
- Studies and participants, as stated
- 8 studies
systematic review · 2012
Mitchell et al. (2012) — Comparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review
- What it measured
- Quantitative sleep outcomes (e.g., sleep latency)
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review of RCTs (PRISMA, GRADE)
- Studies and participants, as stated
- 5 studies
systematic review · 2019
Davidson et al. (2019) — Cognitive behavioural treatment for insomnia in primary care: a systematic review of sleep outcomes.
- What it measured
- Self-reported sleep (sleep diary outcomes and Insomnia Severity Index)
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review
- Studies and participants, as stated
- 13 studies
other design · 2016
Kathol et al. (2016) — Cognitive Behavioral Therapy for Chronic Insomnia: Confronting the Challenges to Implementation
- What it measured
- Implementation challenges of CBT-I as first-line treatment
- How it was read
- screened only, not extracted
other design · 2015
Morin (2015) — Cognitive Behavioral Therapy for Chronic Insomnia: State of the Science Versus Current Clinical Practices
- What it measured
- Efficacy of CBT-I on sleep
- How it was read
- screened only, not extracted
meta-analysis · 1994
Morin et al. (1994) — Nonpharmacological interventions for insomnia: a meta-analysis of treatment efficacy.
- What it measured
- Efficacy and durability of psychological treatments (sleep-onset latency, WASO, awakenings, total sleep time)
- How it was read
- screened only, not extracted
- What the review says it includes
- Meta-analysis of treatment outcome studies
- Studies and participants, as stated
- 59 studies, 2102 patients
meta-analysis · 2011
Okajima et al. (2011) — A meta-analysis on the treatment effectiveness of cognitive behavioral therapy for primary insomnia
- What it measured
- Effect sizes of CBT-I on subjective and objective sleep parameters and self-rating scales
- How it was read
- screened only, not extracted
- What the review says it includes
- Meta-analysis of randomized controlled studies
- Studies and participants, as stated
- 14 RCTs (published 1990-2009)
meta-analysis · 2024
Furukawa et al. (2024) — Components and Delivery Formats of Cognitive Behavioral Therapy for Chronic Insomnia in Adults
- What it measured
- Association of each CBT-I component and delivery format with outcomes (subjective sleep quality, sleep continuity)
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and component network meta-analysis
- Studies and participants, as stated
- 241 trials
randomised controlled trial · 2004
Jacobs et al. (2004) — Cognitive behavior therapy and pharmacotherapy for insomnia: a randomized controlled trial and direct comparison.
- What it measured
- Sleep-onset latency (sleep diaries); secondary: sleep efficiency, total sleep time, objective measures, daytime functioning
- How it was read
- screened only, not extracted
meta-analysis · 2017
Straten et al. (2017) — Cognitive and behavioral therapies in the treatment of insomnia: A meta-analysis.
- What it measured
- Sleep outcomes (ISI, sleep efficiency, PSQI, WASO, SOL, awakenings, sleep quality, total sleep time)
- How it was read
- screened only, not extracted
- What the review says it includes
- Meta-analysis of randomized controlled trials
- Studies and participants, as stated
- 87 RCTs, 118 treatments (3724 treated patients, 2579 controls)
meta-analysis · 2020
Baglioni et al. (2020) — A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials Evaluating the Evidence Base of Melatonin, Light Exposure, Exercise, and Complementary and Alternative Medicine for Patients with Insomnia Disorder
- What it measured
- Sleep-onset, sleep efficiency, insomnia disorder severity
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review and network meta-analysis
- Studies and participants, as stated
- 40 studies in review, 36 in meta-analysis
narrative review · 2013
Bootzin et al. (2013) — Future outlook of nonpharmacological treatments for insomnia in adults: clinical trial progress
- What it measured
- CBT-I efficacy and durability of sleep improvement
- How it was read
- screened only, not extracted
systematic review · 2019
Rios et al. (2019) — Comparative effectiveness and safety of pharmacological and non-pharmacological interventions for insomnia: an overview of reviews
- What it measured
- Clinical effectiveness and safety of pharmacological and non-pharmacological interventions
- How it was read
- screened only, not extracted
- What the review says it includes
- Overview of reviews (64 systematic reviews, 35 with meta-analysis)
- Studies and participants, as stated
- 64 systematic reviews
narrative review · 2012
Harvey et al. (2012) — Sleep Disorders in Adults
- What it measured
- Treatment efficacy for chronic insomnia
- How it was read
- screened only, not extracted
meta-analysis · 2024
Steinmetz et al. (2024) — Network meta-analysis examining efficacy of components of cognitive behavioural therapy for insomnia.
- What it measured
- Insomnia severity
- How it was read
- screened only, not extracted
- What the review says it includes
- Component network meta-analysis
- Studies and participants, as stated
- 80 studies, 15,351 participants
meta-analysis · 2023
Verreault et al. (2023) — The effectiveness of stimulus control in cognitive behavioural therapy for insomnia in adults: A systematic review and network meta‐analysis
- What it measured
- Insomnia improvement
- How it was read
- screened only, not extracted
- What the review says it includes
- Systematic review with network meta-analysis
- Studies and participants, as stated
- 23 studies
meta-analysis · 2016
Kim et al. (2016) — Cognitive Behavioral Therapy for Primary Insomnia: A Meta-analysis
- What it measured
- Sleep parameters (total sleep time, SOL, WASO, sleep efficiency, insomnia severity, sleep belief)
- How it was read
- screened only, not extracted
- What the review says it includes
- Meta-analysis (16 clinical trials)
- Studies and participants, as stated
- 16 trials, 1503 participants
narrative review · 2019
Rossman (2019) — Cognitive-Behavioral Therapy for Insomnia: An Effective and Underutilized Treatment for Insomnia
- What it measured
- CBT-I efficacy relative to medication
- How it was read
- screened only, not extracted
Key sources (20) · 1 not counted
Each source below is shown with its study design and a link to the original study, or, where it is not a completed research paper, with what kind of record it is; those are not counted. This is the audit trail.
meta-analysisThe clinical effects of sleep restriction therapy for insomnia: A meta-analysis of randomised controlled trials.
meta-analysisA meta-analysis of group cognitive behavioral therapy for insomnia.
systematic reviewComparative effectiveness of cognitive behavioral therapy for insomnia: a systematic review
systematic reviewCognitive behavioural treatment for insomnia in primary care: a systematic review of sleep outcomes.
other designCognitive Behavioral Therapy for Chronic Insomnia: Confronting the Challenges to Implementation
other designCognitive Behavioral Therapy for Chronic Insomnia: State of the Science Versus Current Clinical Practices
meta-analysisNonpharmacological interventions for insomnia: a meta-analysis of treatment efficacy.
meta-analysisA meta-analysis on the treatment effectiveness of cognitive behavioral therapy for primary insomnia
meta-analysisComponents and Delivery Formats of Cognitive Behavioral Therapy for Chronic Insomnia in Adults
randomised controlled trialCognitive behavior therapy and pharmacotherapy for insomnia: a randomized controlled trial and direct comparison.
meta-analysisCognitive and behavioral therapies in the treatment of insomnia: A meta-analysis.
meta-analysisA Systematic Review and Network Meta-Analysis of Randomized Controlled Trials Evaluating the Evidence Base of Melatonin, Light Exposure, Exercise, and Complementary and Alternative Medicine for Patients with Insomnia Disorder
narrative reviewFuture outlook of nonpharmacological treatments for insomnia in adults: clinical trial progress
systematic reviewComparative effectiveness and safety of pharmacological and non-pharmacological interventions for insomnia: an overview of reviews
narrative reviewSleep Disorders in Adults
PreprintDismantling cognitive-behavioural therapy for chronic insomnia in adults with or without comorbidities: a systematic review and component network meta-analysis
meta-analysisNetwork meta-analysis examining efficacy of components of cognitive behavioural therapy for insomnia.
meta-analysisThe effectiveness of stimulus control in cognitive behavioural therapy for insomnia in adults: A systematic review and network meta‐analysis
meta-analysisCognitive Behavioral Therapy for Primary Insomnia: A Meta-analysis
narrative reviewCognitive-Behavioral Therapy for Insomnia: An Effective and Underutilized Treatment for Insomnia
Why do some records show a record type instead of a study design?
A study design is shown for a completed, peer-reviewed paper. A registered protocol, a preprint, a conference abstract, a referee report or a book chapter has not been through peer review as a finished paper, so it is labelled for what it is, and it is counted in no source count. Where a record could not be confirmed as a completed paper at all, it says so rather than guessing. They all stay in the list, and their DOI still resolves, because the count of what was screened is part of the audit trail.
- Protocol / registration A registered plan for a review or trial, not its results.
- Preprint Posted by its authors before peer review.
- Conference abstract A conference summary rather than a peer-reviewed paper.
- Peer-review report A referee's report on a paper, not the paper itself.
- Guideline / position stand A recommendation derived from evidence, which is a step further from the data than the evidence itself.
- Book chapter A chapter in a scholarly book rather than a journal paper.
- Type not recorded Our record does not say what kind of publication this is, so it is counted in no source count. That is a gap in our data, not a judgement about the research.
Explore all 891 studies in Sleep →
The full evidence base this focus area draws on, every study with its design and DOI.What it is for
Sleep better