Sleep is a clinical intervention — what an Indian week of CR-aligned sleep looks like

Most of the sleep advice circulating online is written for a Californian software engineer with no children, a private bedroom, and an evening that ends at 9 pm. Indian patients live different lives. The protocol below is the one I actually use in clinic, adapted for noisy buildings, late dinners, joint families and 7 am school runs.

Fix the wake time. Not the bedtime. Pin it to within a 30-minute window across all seven days, including weekends. The body's circadian system is anchored by the morning, not the evening. Once the wake time is stable, bedtime will pull itself toward the right place inside two weeks.

Day 1 — Set the wake time. Place the phone outside the bedroom for the night. Day 2 — Add 10 minutes of natural daylight within an hour of waking, even if it's just on the balcony. Day 3 — Move the last cup of chai/coffee to before 2 pm. Day 4 — Begin the 90-minute pre-bed wind-down: dim lights, no work, no scrolling, no charged conversations. Day 5 — Add a 4-minute paced-breath session (4 in, 7 out) the moment your head touches the pillow. Day 6 — If you are awake more than 20 minutes, get out of bed, sit in dim light, return only when sleepy. Day 7 — Audit and forgive. One bad night does not undo six good ones.

Earplugs are clinical equipment, not luxury. A pair of soft silicone earplugs reliably drops the ambient noise floor enough for the brain to commit to deep sleep. A blackout curtain is the second piece of equipment. A small fan for white noise is the third. None of these cost more than a single therapy session and they pay for themselves within a month.

If the protocol above is run honestly for three weeks and sleep onset is still over 30 minutes most nights, or you are waking before 4 am with rumination, take the ISI on this site. A score above 14 is the threshold at which CBT-I plus Cognitive Regulation work outperforms anything you can do on your own.