My Sleep Window: A Plain-Language CBT-I Sleep Diary and Client Worksheet
CBT · CBT · Manualised
The client-facing companion to the CBT-I Sleep Restriction Worksheet. Where the clinician sheet carries the sleep-efficiency arithmetic and the titration rule, this sheet asks the client for only what they can report reliably each morning: when they got into bed, roughly how long it took to fall asleep, how often they woke, when they got up and how sleepy the day felt. The clinician converts those entries into a sleep-efficiency figure at review. The sheet also restates the standing rules in plain words (fixed wake time, the 20-minute rule, bed for sleep only), gives the client a place to park worries instead of rehearsing them in bed, and asks them to flag drowsiness that makes driving or using equipment unsafe.
Underlying mechanism: Client-Facing Sleep Diary for Sleep Restriction and Stimulus Control
What it helps with
- Getting a usable morning-by-morning record without asking the client to calculate anything.
- Making the fixed wake time, the 20-minute rule and the no-napping rule explicit as instructions rather than advice.
- Keeping pre-sleep worry out of bed by giving it a written place to go.
- Flagging daytime drowsiness early, during the first two weeks of a restricted window.
How clinicians use it
- Complete the top panel with the client in session: fixed wake time, prescribed bedtime and the date of the next review. Do not send it home with the window blank.
- Explain that entries are best guesses made each morning. Precision is not needed, and clock-watching during the night makes sleep worse, so the client should not check the time to fill this in.
- Calculate sleep efficiency yourself from the diary at review, and apply the titration rule on the clinician sheet. The client sheet deliberately contains no percentage.
- Name the expected dip in daytime energy in weeks one and two before it happens, and agree in advance what the client does if drowsiness makes driving or using equipment unsafe.
- For ADHD or autistic clients, offer a reminder alarm at a fixed time each morning and accept one-word or tick entries; a partly completed diary is far more useful than none.
- Where worry rather than habit is the main driver, pair with the Worry Postponement Worksheet and use the worry parking box as the bridge.
Clinical Implementation Guide
- Fill the fixed wake time and bedtime in with the client before they leave the session.
- Ask for best guesses each morning, with no clock-watching during the night.
- Convert the entries to sleep efficiency yourself at review and apply the titration rule on the clinician sheet.
What the worksheet looks like
| Night | Got into bed | Minutes to fall asleep | Times awake | Got up for the day | Sleepiness next day (0-10) |
|---|---|---|---|---|---|
| Mon | 01:00 | 30 | 2 | 07:00 | 6 |
| Tue | 01:00 | 20 | 1 | 07:00 | 5 |
| Wed | 01:00 | 15 | 1 | 07:00 | 4 |
Clinical cautions
Use only within a formulation-led CBT-I plan set by a qualified practitioner who has screened for untreated sleep apnoea, bipolar disorder, seizure disorder, shift work and safety-critical daytime responsibilities. Restricting time in bed can increase daytime sleepiness, so clients must be told plainly not to drive or use machinery when drowsy and to contact their clinician if that happens. This sheet does not diagnose insomnia or any other condition, is not a substitute for individual face-to-face therapy or medical assessment, and does not replace emergency or crisis support. If low mood or thoughts of self-harm accompany the sleep problem, the client should contact their clinician, GP or local crisis service. AI assisted in drafting; clinical content requires review and sign-off by Dr. Rich Pomfret.
References
- Spielman, A. J., Saskin, P., & Thorpy, M. J. (1987). Treatment of chronic insomnia by restriction of time in bed. Sleep, 10(1), 45-56.
- Bootzin, R. R. (1972). Stimulus control treatment for insomnia. Proceedings of the American Psychological Association, 7, 395-396.
- Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., & Denberg, T. D. (2016). Management of chronic insomnia disorder in adults: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 165(2), 125-133.
- Edinger, J. D., & Carney, C. E. (2014). Overcoming insomnia: A cognitive-behavioral therapy approach, therapist guide (2nd ed.). Oxford University Press.
Part of
Cognitive Behavioral Therapy (CBT) Foundations
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