Getting your sleep back: the Psychotip® programme

Frequently asked questions

I can't afford to be tired at work: what can I do? That is a serious objection. Two answers: start during a quieter period or a holiday if you can; and if you cannot, start with a window slightly wider than the calculation indicates, a little less effective, but sustainable. A protocol applied at 80 % is worth infinitely more than a perfect protocol abandoned on day three.

What if I can't stay awake until bedtime? Standing up, light activity, medium lighting, not the sofa: that is where you fall asleep without meaning to and lose the pressure you have built. For the first two weeks, the evening needs a plan: go out, tidy, walk, call someone.

Don't I need eight hours of sleep? It is the most widespread belief and it is false as an individual norm. Need varies from about six to nine hours between people, and decreases with age. The right indicator is not a figure, it is how you are during the day.

Is a sleepless night dangerous? Not in itself. It is unpleasant, it degrades mood, attention and driving the next day, hence the caution at the wheel. But the body recovers, and the fear of the sleepless night maintains insomnia far more than the sleepless night itself.

How long before I see a change? Falling asleep often gets quicker from the second week. Sleep continuity improves between the third and the fifth. The sense of refreshing sleep comes last, sometimes after the sixth week.

Can I do this programme while taking a sleeping pill? Yes, and that is in fact the right order: install the protocol, then reduce the medication gradually, with the prescriber. Change nothing on your own.

Can an app or an online programme help me? Yes, provided it genuinely applies the method. Online programmes of cognitive behavioural therapy for insomnia, some of them fully automated, have shown their effectiveness in large trials. Check that it has you keep a diary, calculate a sleep window and apply stimulus control: an app that only offers soothing sounds or a sleep score is not this treatment. And be wary of the scores that watches and wristbands calculate: checked every morning, they keep sleep monitoring going (section 8).

How do I manage with the person who shares my bed? Explain the programme to them before you start: for a few weeks, you will go to bed later and may get up during the night, and this is not you drawing away, it is the treatment. Keep a moment together before they go to bed, which does not have to coincide with the time you fall asleep, and plan a way of getting out of bed that does not wake them. If the nights are too disrupted, sleeping in separate beds or rooms during the difficult weeks is a reasonable temporary solution. Above all, ask them not to comment on your sleep every morning. They can, on the other hand, tell you whether you snore, whether your breathing stops or whether your legs move at night, and that is worth mentioning to your doctor.

Should I have a sleep recording before starting? Not for insomnia: the diagnosis rests on what you describe and on your diary. A night's recording, called polysomnography, is useful when something else is suspected: snoring with breathing pauses, marked daytime sleepiness, leg movements, abnormal behaviour during sleep, or insomnia that resists properly conducted treatment (sections 22 and 25).

I am over seventy: is this programme right for me? Yes. Cognitive behavioural therapy for insomnia has been evaluated in older people, and in this age group its effects are maintained better than those of a sleeping pill. Sleep naturally becomes lighter and a little shorter over the years, so some of the wakings are normal. A few adjustments matter more at this age: compression, more gradual than outright restriction, is often suggested out of caution (section 10), and at night the route to the armchair must be safe (section 12). At this age, sleeping pills increase the risk of falls and of memory problems: that is one more reason to talk to your doctor about a gradual reduction.

Will I ever be able to nap again? Not during the programme, except for the safety exception in step 4: a nap of twenty minutes at most, before 3 p.m., if you absolutely have to drive and you are sleepy. Once sleep has stabilised, a short nap, taken early in the afternoon and always at the same time, can be considered, particularly for an older person. The criterion is simple: if your falling asleep in the evening gets worse, the nap costs more than it brings, and you drop it.

My insomnia began after a bereavement or a serious event: do I need to treat that first? Not for your sleep. As section 5 explains, what maintains established insomnia is, most often, no longer what triggered it, and the programme can begin without waiting. If grief remains overwhelming months after a loss, our guide Grief: understanding it, getting through it, and knowing when to ask for help helps you take stock. And if a serious event comes back as intrusive memories, nightmares or startle reactions, our guide Post-traumatic stress: understanding it and rebuilding describes this disorder and the treatments that help; work on sleep fits in very well alongside them.