One of the more paradoxical CBT-I methods used to help insomniacs sleep is to restrict their time spent in bed, perhaps even to just six hours of sleep or less to begin with. By keeping patients awake for longer, we build up a strong sleep pressure—a greater abundance of adenosine. Under this heavier weight of sleep pressure, patients fall asleep faster, and achieve a more stable, solid form of sleep across the night. In this way, a patient can regain their psychological confidence in being able to self-generate and sustain healthy, rapid, and sound sleep, night after night: something that has
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