| Cognitive behavior therapy | Helps change incorrect beliefs and attitudes about sleep (e.g., unrealistic expectations, misconceptions, amplifying consequences of sleeplessness); techniques include reattribution training (i.e., goal setting and planning coping responses), decatastrophizing (aimed at balancing anxious automatic thoughts), reappraisal, and attention shifting |
| Exercise | Moderate-intensity exercise (should not occur just before bedtime) |
| Relaxation therapy | Tensing and relaxing different muscle groups; biofeedback or imagery (visual and auditory feedback) to reduce somatic arousal; meditation; hypnosis |
| Sleep restriction (paradoxical intention therapy) | Uses a paradoxical approach in which the patient spends less time in bed (by associating time spent in bed with time spent sleeping) |
| Bedtimes are then increased or decreased progressively depending on improvement or deterioration of sleep quality and duration |
| This state of minimal sleep deprivation eventually leads to more efficient sleep |
| Stimulus control therapy | Avoid bright lights (including television); noise and temperature extremes; and large meals, caffeine, tobacco, and alcohol at night |
| Minimize evening fluid intake; leave the bedroom if unable to fall asleep within 20 minutes; limit use of the bedroom to sleep and intimacy |
| Temporal control measures | Consistent time of wakening; minimal daytime napping |