Using it in CBT-I

The diary asks the core questions of a standard sleep diary, worded closely to the Consensus Sleep Diary without copying it. When the person got into bed, when they tried to sleep, how long it took, how often and how long they were awake, the final waking, and when they got up, plus a rating of the night. Total sleep, time in bed, and efficiency are worked out the standard way, and a night missing anything the math needs is saved as Partial and left out of every average. Optional questions about the day before cover naps, caffeine, alcohol, exercise, screens, and anything taken for sleep. They’re shown next to the nights and never feed the window.

The sleep window follows the protocol taught in most treatment manuals. One to two weeks of baseline, a fixed wake time seven days a week, time in bed set to average total sleep, and a weekly check that suggests 15 minutes earlier at 90% efficiency or higher, no change from 85 to 89%, and 15 minutes later under 85%. The floor is 5 hours and 30 minutes. Clinician-led protocols often go to 5, but a self-guided tool should be more careful. A week with fewer than 5 complete nights gets no suggestion, and a week spent mostly outside the window is named as such, with the window kept the same that week. Sleep compression is offered as the gentler start.

If you adjust the thresholds for someone, for example moving bedtime earlier at 85% for an older adult, follow your own plan. The tool never moves a window on its own, so the person can keep the one you set and use the diary for the numbers.

The stimulus control rules sit under the window. In the app, worry time, a wind-down routine, relaxation exercises, and a short look at common beliefs about sleep cover the cognitive and arousal side. For a structured look at one thought, the app points to Thought Record.

The diary report

The online diary and the app make the same report, laid out by the same code. It covers one or two weeks. It opens with averages for each seven-morning block. Time in bed, total sleep, time to fall asleep, time awake in the night, sleep efficiency pooled across the week, and the sleep rating. Then come the sleep window and its history, with every start, weekly check, and change. In the app, Sleep Condition Indicator scores follow. The nights are laid out one per row, partial nights marked, with habits, the day before, and notes after them, and a short note on how the numbers are worked out closes it.

The person makes the report and decides where it goes. Nothing is sent anywhere on its own. Times are their own estimates, entered each morning, and the report says so.

Printables

One and two week sleep diaries, a sleep window worksheet, a stimulus control handout, and a wind-down routine, each as a fillable PDF and a print PDF, in English and Spanish. See the printables.

Groups

Everyday Insight is adapting each of its tools for group therapy, and a group version of Sleep Toolbox is planned, with materials for running CBT-I with several people at once. There’s no date for it yet.

The Sleep Condition Indicator

The app offers the Sleep Condition Indicator as an optional check-in every few weeks. It shows the score from 0 to 10 with one line, “Higher means better sleep,” and nothing more. It never shows the cutoff for probable insomnia disorder, and scores go into the report for you to read in context.

The Sleep Condition Indicator is © Sleepio Limited and is used under a Creative Commons Attribution-NonCommercial 4.0 International license, creativecommons.org/licenses/by-nc/4.0. Everyday Insight shows the questions on one page, writes the ranges out in words, and moved the note on the second question below it. Espie, C. A., Kyle, S. D., Hames, P., Gardani, M., Fleming, L., & Cape, J. (2014). The Sleep Condition Indicator: A clinical screening tool to evaluate insomnia disorder. BMJ Open, 4(3), e004183. https://doi.org/10.1136/bmjopen-2013-004183

What it doesn’t do

It doesn’t diagnose insomnia or screen for sleep apnea, restless legs, or other sleep disorders, and it never tells anyone they’ve improved. Its Learn article on when to see a doctor names the signs worth checking, and the “Before you start” page asks people with bipolar disorder, seizure disorders, sleep apnea, parasomnias, a history of falls, medicine that makes them drowsy, pregnancy, or safety-sensitive work to talk with a health care provider first.

Not a HIPAA-covered service. There are no accounts and no server of ours. What a client enters stays in their browser or on their device, or in their own iCloud or Google Drive if they turn on sync in the app. Anything they share with you becomes part of your records and your obligations.

The research

The research page names the sources behind each part and what the American College of Physicians and American Academy of Sleep Medicine guidelines recommend. The Learn articles are written for clients and are the same ones in the app.