침대는 잠자는 곳으로Bed Is for Sleep

1. When bed becomes the place you lie awake

Do you feel more alert the moment you lie down? Do you nod off on the couch, only to feel wide awake once you get into bed?

After a long stretch of poor sleep, your body learns that bed is where you toss, turn, worry, and scroll. Lying down can become a cue to wake up. That’s a learned response more than a matter of willpower. Psychologists call it conditioning.

What’s learned can be relearned. The method for this is called stimulus control (Bootzin, 1972).

2. Five agreements

The first few nights, you may get up and go back to bed several times. That’s your bed relearning.

For safety: keep a night light on for getting up in the dark. If you’re at risk of falling or have physical limitations, adjust agreement 3 with your therapist. Sitting in a chair beside the bed is one option.

3. What to do when you get up

The goal is to wait comfortably until sleepiness comes.

• Keep lights low and warm
• Do something a little boring but not unpleasant: a paper book, a puzzle, knitting, folding laundry, quiet music
• Better to avoid: work, email, shopping, social media, planning tomorrow, bright screens
• Decide ahead of time. Figuring out what to do at 2 a.m. raises arousal too.

My list: ______________________

4. If your life spans two time zones

If your family lives in another country, calls tend to happen on their clock. For families in Korea, that often pushes calls late into the night or into the early morning here, and it can be hard to settle down afterward.

• When possible, wrap up calls one to two hours before bed. If your evening is their morning or midday, that’s a good window.
• If you worry about missing an emergency call overnight, set Do Not Disturb with exceptions for family numbers.
• After a trip abroad, keeping a fixed wake time and getting morning sunlight helps your body readjust.

5. Adjustments for neurodivergent sleepers

There’s still little research on adapting CBT-I for neurodivergent people. These are clinical suggestions based on general principles.

• Sleepiness can be hard to notice. Some people find it hard to read body signals (interoception). If so, you can use the bedtime you and your therapist set as your cue, instead of waiting to feel sleepy.
• Set up the sensory environment first. Sound, light, the weight and texture of your blanket, the seams on your sleepwear. White noise or blackout curtains help some people. If you have a respiratory or circulatory condition, check with a medical provider before using a weighted blanket, and take particular care with children.
• Plan out-of-bed activities in advance. Special interests that are easy to get absorbed in are better saved for daytime.
• Stimming that helps your body settle is fine to use, and you don’t need to hide it.

6. Things that affect sleep

• Caffeine: stays in your body for several hours or more. Try cutting back after early afternoon. It’s also in tea, energy drinks, chocolate, and some pain relievers.
• Alcohol: may help you fall asleep, but it makes early-morning sleep lighter and more broken. If a nightcap has become your sleep aid, talk with your therapist. Stopping daily heavy drinking suddenly can be dangerous, so plan any reduction with a medical provider.
• Nicotine: is a stimulant. Smoking when you wake at night also breaks up sleep.
• Melatonin: studies have found that the actual amount in supplements can differ widely from the label, including a study of melatonin gummies sold in the US (Erland & Saxena, 2017; Cohen et al., 2023). The American Academy of Sleep Medicine does not recommend melatonin for treating chronic insomnia (Sateia et al., 2017). When the internal clock is set late, though, a small dose taken at a specific time can sometimes help. Whether, when, and how much to take is a question for your prescriber or pharmacist.
• Stimulants such as ADHD medication: timing can affect sleep. Talk with your prescriber before changing anything.
• Other medications: steroids, decongestants, and some antidepressants can affect sleep. If you take medication, check with your prescriber or pharmacist.