• cognitive-behavioral treatment;
  • insomnia;
  • pre-sleep routine


This uncontrolled trial evaluated the feasibility, acceptability, and initial changes in sleep associated with a novel cognitive-behavioral treatment for insomnia, the pre-sleep routine. Patients were encouraged to develop a “sacred” bedroom space only for sleep or sex, and a ritual for entering it. Nine chronic insomniacs (seven women, mean age, 57.9 ± 12.9 years) who met International Classification of Sleep Disorders Diagnostic and Coding Manual, second edition (ICSD-2) criteria for primary insomnia completed daily sleep diaries throughout four weekly sessions and a 15-min booster session. Post-treatment and 1-month follow-up data indicated that the pre-sleep routine was well liked and associated with numerous self-reported improvements in sleep and daytime functioning. These findings need to be interpreted cautiously in light of the small sample and uncontrolled design.