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antagonism · 2
Sleep restriction therapy makes daytime sleepiness worse for the first few weeks, so someone with untreated sleep apnea should not try it on their own; that would stack two things that both erode alertness. For these patients, continuous positive airway pressure (CPAP) comes first, then cognitive behavioral therapy for insomnia.
A sleep hygiene checklist is not wrong; it removes obvious obstacles. Caffeine has a half-life of about 5–6 hours, with wide individual differences, so stopping early in the afternoon makes sense. But in most trials of cognitive behavioral therapy for insomnia, sleep hygiene is what the control group gets; on its own it does not cure chronic insomnia.
regulates · 3
→Sleep Architecture & Sleep Debt
Stimulus control in cognitive behavioral therapy for insomnia (CBT-I) is not about toughing it out; it retrains the bed to signal sleep. It works on sleep pressure and conditioning, not by directly deepening any one stage of sleep. The American Academy of Sleep Medicine guideline gives CBT-I a strong recommendation.
Cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment for chronic insomnia (a strong recommendation in the American Academy of Sleep Medicine guideline, with consistent results across pooled trials), not a sleep tip: stimulus control retrains the bed as a signal for sleep, and sleep restriction compresses broken sleep back into one block. Reaching for pills first gets the order backward.
→Autonomic Nervous System · HRV
In the hyperarousal model, people with chronic insomnia are tilted toward an on state around the clock, not just unable to sleep at night; on the autonomic side this shows up as lower heart rate variability (HRV) and a higher heart rate at night, with sympathetic tone that never switches off.