Why most people quit in month one

Ruth Amadi nearly abandoned treatment in week three, along with, historically, about a third of everyone else on the service.

Sleep hygiene alone has a poor evidence base as a standalone treatment, which is awkward, because it is the most widely distributed sleep advice in existence.

The window widens

Adherence to therapy is reviewed at two weeks, six weeks and three months, because almost all abandonment happens inside the first month.

Almost all abandonment happens in the first month. So almost all our contact is in the first month now.

Dr. Helena Braddock, sleep medicine

Restriction, then expansion

Time in bed is compressed to match time actually asleep, then widened week by week as efficiency climbs. It is counter-intuitive by design and explained as such in session one.

Twelve-month continuation on the redesigned pathway runs twenty-one points higher. “Week three,” she says. “It’s all about week three.”