Understanding Insomnia Part 5 

Keeping sleep diaries is an essential part of CBT-I. Here is my sleep diary. I’ll discuss some of the key data points. It’s important to note that I don’t have insomnia so my diary won’t be consistent with what would typically be seen in a CBT-I patient.  
 
Here are some of the key data points: 
1️⃣ Variation in bed times  
2️⃣ Variation in wake times
3️⃣ Time in bed (TIB) = elapsed time from BT to WT 
4️⃣ Total sleep time (TST) = total time asleep 
5️⃣ Frequency and duration of naps 
6️⃣ Caffeine/Alcohol/Substance Use  
 
❇️ Next, I will calculate a weekly AVERAGE for my TIB and TST. This will allow me to calculate sleep efficiency. This is a metric we use in CBT-I that helps determine the individualized components for the program.  
 
❇️ Sleep efficiency = TST/TIB x 100  
My data = SE = 6.21/6.47 x 100 = 95% 
Most patients with chronic insomnia will have a SE < 80%. A combination of sleep restriction, stimulus control therapy, and small adjustments over time yield improvements.    ❇️ The sleep history is essential to be able to interpret the diaries in clinical context.     ❇️ Thoughts on my log:    ‼️I feel sleepy during the day and require a nap if I’ve slept less than 7 hours  ‼️I need to go to bed by 10:45 PM to ensure 7 hours of sleep minimum but feel even better if I go to bed earlier .  ‼️I need more sleep than I am getting.     ✅ I don’t consume caffeine, alcohol, sleep aids or other substances.  ✅ My wake time is very regular with a goal of being in the same hour daily  ✅ Naps don’t impact my ability to fall asleep at night  ✅ My sleep efficiency is very high. Interpreted in the context of my TST, I should go to bed around 10 pm more consistently to optimize my sleep and reduce my need for a daytime nap.     My sleep history would reveal that my bedtimes were delayed this week because of fireworks being set off by neighbors which is not a usual occurrence.   In any case it’s very easy for me to see that I require a minimum of 7 hours of sleep per night in order to feel rested the next day.     What did you learn from keeping a one week sleep diary?