Goal-setting in sleep therapy
In behavioural sleep medicine (and psychotherapy more generally speaking), goal-setting is an important part of treatment.
This is because we want each person to get what they want out of treatment when it comes to improving their sleep. As clinicians, we can provide information on areas that the person can improve, but goals for sleep health should always come from the patient themselves.
Moreover, goal-setting is a helpful process because it can also elucidate interesting biases in people’s thinking about what constitutes good sleep.
People with chronic insomnia often have exaggerated thoughts about how good sleepers tend to sleep. For example, they may think good sleepers immediately fall asleep the second they get into bed, sleep throughout the night, and wake up refreshed 8 hours later. This process allows us to debunk some myths about sleep and help them set measurable, strong goals to work on based on their complaints about sleep. Below, I discuss 6 measurable sleep goals that are achievable, realistic, ‘good’ goals to have in order to support sleep health.
Goal #1: Falling asleep within 10 to 30 minutes on average
When it comes to time to fall asleep, a goal of falling asleep around 10 to 30 minutes on average tends to be a reasonable goal. People with insomnia typically take more than 30 minutes to fall asleep, while less than 10 minutes may be an indicator of excessive sleepiness.
Note that the word average should be taken into consideration. Even the best of sleepers sometimes have difficulty falling asleep because of stress or poor sleep hygiene. Expecting perfection can lead to sleep anxiety, which can lead to more sleep disruptions.
Goal #2: Staying asleep for most of the night, with a couple of brief awakenings
Generally, we consider sleep to be well-consolidated when there are minimal awakenings we remember throughout the night. People can experience many awakenings throughout the night, but usually only a couple are significant enough for our brain to encode into our memory.
A good goal is usually to stay asleep with a couple brief awakenings (e.g., going to the bedroom) before falling back asleep within a couple minutes. It’s not quite reasonable to expect to be out like a light for 8 hours straight – awakenings in the middle of the night are normal and no cause for concern.
Goal #3: Having a regular routine for going to bed and waking up
Regular bed and rise times help to create a strong internal clock (circadian rhythm), so our body knows when to send sleepy signals and when to tell us we should be awake.
Lots of variability in our routine can lead to symptoms of jetlag – we may feel groggy throughout the day, feel sleepy, feel hungry and alert at random times, and overall feel off.
Therefore, keeping ourselves to a generally regular sleep and wake pattern (e.g., within a 1-hour variability) can be helpful to ensure we feel consistent throughout the day and night.
Goal #4: Feeling better in the morning faster
Although it’s somewhat tough to always feel good in the morning immediately upon waking up because of something called sleep inertia, it is possible is to break through the sleep inertia quicker to feel more energetic in the morning.
Strategies to break sleep inertia can be getting out of bed as quickly as possible once you wake up, doing some light physical activity (e.g., taking a walk), drinking water, getting some light exposure, taking a shower, and listening to energetic music. By contrast, staying in bed and scrolling through our social media feed can make it harder to move past the sleep inertia.
Goal #5: Figuring out the causes of lack of energy during the day
Usually, people tend to base their lack of energy throughout the day on poor sleep. Although poor sleep can absolutely be a contributor to fatigue, there are many reasons why someone can feel tired throughout the day.
This is why I always encourage a curious approach to determining whether improved sleep necessarily improves how a person feels during the day when goal-setting. Although behavioural treatments of insomnia can definitely change how we sleep, it may not necessarily change how we feel in the daytime.
Goal #6: Determining the right number of hours for you
Some people make it a goal to get a certain amount of sleep primarily because they have heard from a variety of sources that 8 hours of sleep is what you need to feel good and healthy.
However, the reality is that everyone’s sleep needs are different and striving for 8 hours of sleep can cause insomnia in some cases.
The idea in behavioural sleep medicine and cognitive behavioural therapy is to find the number of hours that best fit you – like a shoe size that feels comfortable on your feet. By finding our magic number, we reduce excessive time in bed awake and enjoy deeper restorative sleep.
Today, we discussed a few sleep goals that are attainable when we look towards behavioural sleep medicine to support our sleep health. Setting realistic and measurable goals are great ways to optimize our sleep health and ensure we are not being too perfectionistic about our sleep.
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