按真正的教练流程开会：先定产出、再用短问、给出带日期与验证的承诺，并在签约时设计好结束节点。
58 次安装3 星标
编程
Sleep
先做分诊再跑协议：用量化方案处理失眠、时差、轮班、咖啡因与褪黑素时机；遇到红旗症状直接转介临床，不在危险方向继续指导。
它能做什么
睡眠指导以分诊为前提：任何主诉先过一遍红旗筛查（睡眠呼吸暂停、发作性睡病、REM 行为障碍、不宁腿、孕期呼吸异常等），可疑即转介医生，协议不再继续。活跃内容包括失眠 CBT-I 精简版（刺激控制 + 睡眠限制）、基于 Tmin（起床时间减 2.5 小时）推算的时差光照窗口、轮班锚定睡眠，以及咖啡因、酒精、0.5 mg 褪黑素的截止时间与剂量。日历、出差计划与偏好保存在 ~/Clawic/data/sleep/，每周只新增一个干预，用日记做效果判定，不叠加改动。
什么时候用它
- 连续几个月凌晨 3 点醒来
- 本周要跨越 3 个及以上时区出差
- 轮夜班导致白天睡眠支离破碎
- 伴侣打鼾、新生儿或更年期把夜晚切碎
技能文档
Operational sleep coaching: triage the complaint, run the protocol with numbers, route red flags to a clinician instead of coaching past them. Advise mode only: guide the human, never touch their medication. Diary, trip plans, and preferences persist in ~/Clawic/data/sleep/ (see setup.md on first use, memory-template.md for the file format; created only when the user starts a protocol). If you have data at an old location (~/sleep/ or ~/clawic/sleep/), move it to ~/Clawic/data/sleep/.
When To Use
- User reports trouble falling asleep, 3am waking, early waking, or daytime tiredness.
- Trip planning across time zones: build the light and melatonin schedule before departure.
- Scheduling questions touching sleep: nap timing, caffeine cutoff, workout placement, chronotype.
- Night shifts or rotating schedules: damage-control plan, not adaptation fantasies.
- Nightmares, sleep paralysis, sleepwalking, snoring partner, tracker data, or sleep during pregnancy, new parenthood, menopause, or past 65.
- Not for diagnosing sleep disorders: snoring with gasps, dream enactment, sleep attacks go to a clinician (→ Red Flags). Not for dream journaling (
dreamsskill).
Quick Reference
| Situation | Play |
|---|---|
| Bad sleep < 3 months, tied to a stressor | Acute: hold wake time, ban naps and early bedtimes, wait it out (→ insomnia.md) |
| Bad sleep ≥ 3 nights/week for ≥ 3 months | Chronic insomnia (ICSD-3): run CBT-I lite (→ insomnia.md) |
| Loud snoring + witnessed pauses + sleepy days | Stop coaching, refer for a sleep study (→ Red Flags) |
| Cannot fall asleep before 2-3am but sleeps fine when free-running | Delayed phase, not insomnia — restriction is the wrong tool (→ circadian.md) |
| Waking 4-5am done sleeping, often age 60+ | Advanced phase vs mood — screen both (→ circadian.md) |
| Crossing ≥ 3 zones AND ≥ 3 nights there | Adapt: compute Tmin, schedule light by direction (→ jetlag.md) |
| Crossing < 3 zones OR < 3 nights there | Rule of 3: stay on home time, book meetings in the overlap window |
| Night or rotating shifts | Anchor sleep + commute light control (→ shiftwork.md) |
| "Should I nap?" | 10-20 min, finished ≥ 8 h before bedtime; never during an insomnia protocol (→ performance.md) |
| Big day after a bad night, or an unavoidable all-nighter | Damage control: nap math, caffeine timing, no-drive line (→ performance.md) |
| Tracker score bad, user feels fine | Trust daytime function; stage data is noise (→ trackers.md) |
| "What supplement helps?" | Melatonin 0.5 mg timed for phase shift; everything else is weak (→ substances.md) |
| Nightmares, sleep paralysis, sleepwalking, night terrors | Identify by timing and recall, treat or refer (→ parasomnias.md) |
| Teen, pregnant, new parent, menopause, 65+ | Base protocols carry modifiers (→ populations.md) |
| Room too hot, bright, loud; partner snores; kids or pets in bed | Fix the environment before blaming the sleeper (→ environment.md) |
| Weekend "catch-up" sleep | Cap wake-time drift at 1 h; 2 h drift = social jet lag and a Monday relapse |
| Any other sleep complaint | Start the 7-day diary in ~/Clawic/data/sleep/diary.md; no intervention before data |
Depth on demand: insomnia.md full CBT-I lite, 3am playbook, relapse plan · jetlag.md direction math, worked trip tables, pre-flight shifting · shiftwork.md anchors, rotation design, first-night survival · circadian.md night owls, larks, DSPS, light therapy · environment.md bedroom, noise, partners · substances.md every cutoff and dose · trackers.md what to read, what to ignore · parasomnias.md nightmares to sleepwalking · populations.md life stages · performance.md naps, debt, all-nighters.
Core Rules
- Wake Anchor: one fixed wake time ±30 min, 7 days/week; bedtime floats with sleepiness. Highest-leverage single change; check that weekend wake stays within 1 h of weekday wake.
- Judge sleep by daytime function, not hours. Adult range is 7-9 h (consensus guidelines), not a universal 8: alert on 6.5 h = that user's number; sleepy in meetings after 8 h = a problem despite the hours.
- Triage before advice: every complaint passes the Red Flags table first. Hygiene tips given to an apnea case cost a year of misdirection.
- Stimulus control (Bootzin): awake ~20 min by feel (no clock-checking), leave the bed, dim light, boring analog activity, return only when sleepy. Best-evidenced single insomnia technique.
- Effort inverts in sleep: "try to sleep more" always backfires. Prescribe the opposite: later bedtime, restricted window, worry scheduled earlier in the evening.
- Time substances by half-life, not by feel: caffeine last dose ≥ 8 h before bed, alcohol last drink ≥ 3 h, melatonin 0.5 mg taken 5 h before target bedtime when the goal is shifting the clock.
- Light steers the clock and direction depends on timing: light after Tmin advances the clock, before Tmin delays it. Tmin = habitual wake minus 2.5 h (wake 07:00 → Tmin 04:30). Backwards application makes jet lag worse.
- One intervention per week, measured against the diary. Stacked changes make results unattributable; the diary is ground truth, not memory of the night.
Red Flags
| Signal | Suspicion | Action |
|---|---|---|
| Loud snoring + witnessed breathing pauses or gasp-awakenings + daytime sleepiness | Obstructive sleep apnea | Refer for a sleep study before any protocol |
| Dozing while driving, or sleep intruding mid-conversation | Severe sleepiness (Epworth-range > 10) | Refer promptly; advise against driving drowsy now |
| Acting out dreams: punching, kicking, leaping, mostly age 50+ | REM behavior disorder | Neurologist referral, not urgent but not optional |
| Evening leg discomfort with urge to move, relieved by movement | Restless legs | Clinician; low ferritin is the common driver |
| Sudden sleep attacks, knees buckling with laughter | Narcolepsy/cataplexy | Sleep specialist |
| Insomnia + hopeless 3am thoughts, mood collapse | Depression presenting as insomnia | Treat mood as primary; escalate per user's care setup |
| New snoring or gasping in pregnancy, morning headaches, rising blood pressure | Pregnancy apnea / preeclampsia risk | Prompt obstetric review, not sleep coaching |
| Night waking driven by pain, reflux, or breathlessness | Medical driver wearing an insomnia mask | Treat the driver first; sleep protocols wait |
Anything in this table suspends the protocols in this skill: route to a clinician.
Output Gates
- Did this complaint pass the Red Flags table before any protocol advice?
- Does every melatonin mention carry both dose and clock time (0.5 mg, 5 h before target bedtime for phase shifts)?
- Is prescribed TIB clamped to the floor in
insomnia.mdand the bedtime phrased as "not before"? - Are jet lag light windows derived from Tmin converted to destination clock, not from local sunrise?
- Am I prescribing exactly one new intervention this week, with the diary as the measure?
- If the user is a teen, pregnant, postpartum, menopausal, 65+, or on shifts, did I apply the modifiers in
populations.md/shiftwork.md?
Configuration
User-dependent variables. Defaults apply until the user states a preference; store them in ~/Clawic/data/sleep/config.yaml.
| Variable | Type | Default | Effect |
|---|---|---|---|
| wake_anchor | time (HH:MM) | none | Seeds every derivation: Tmin = wake_anchor − 2.5 h, earliest bedtime, nap cutoff; unset → derive from a 7-day diary |
| time_format | 12h | 24h | 24h | Formats every schedule, worked example, and trip-plan table |
| units | metric | imperial | metric | Bedroom temperature guidance (16-19 °C vs 60-67 °F) and any other physical figure |
| tracker | text (device name) | none | Tailors trackers.md guidance to the metrics that device reports; none → coach from the diary only |
Preference areas to record as the user reveals them:
- schedule — work pattern (office hours, shifts, on-call, freelance), fixed commitments; affects anchor placement and every protocol window
- household — partner schedule, kids, pets, room sharing; affects
environment.mdplays and stimulus-control feasibility - substances — what the user actually uses (caffeine dose and timing, alcohol, THC, prescriptions); affects which cutoffs get surfaced first
- risk posture — how aggressively to titrate restriction, how firmly to repeat referrals; affects
insomnia.mdtitration and Red Flags delivery - reporting — plan format (per-day table vs prose), diary check-in cadence; affects artifacts written to
~/Clawic/data/sleep/
Traps
| Trap | Why it fails | Do instead |
|---|---|---|
| Sleeping in after a bad night | Dilutes sleep pressure, delays the clock, seeds the next bad night | Same wake time; earlier sleepiness tonight is the repayment |
| Earlier bedtime to get more sleep | More time awake in bed conditions bed = frustration | Later bedtime until SE ≥ 90%, then extend by 15 min steps |
| Weekend catch-up ≥ 2 h | Social jet lag (Roenneberg): Sunday-night insomnia, Monday impairment | Cap drift at 1 h; 20-min Saturday nap if needed |
| Hygiene tips for chronic insomnia | Hygiene alone shows near-zero effect on chronic cases; it is prevention | CBT-I components: restriction + stimulus control |
| Nightcap for sleep | Onset improves, second half fragments | ≥ 3 h alcohol buffer; treat latency with restriction |
| 10 mg melatonin at lights-out for jet lag | Wrong dose and wrong hour; sedation misread as adaptation | 0.5 mg, 5 h before target bedtime, eastward only |
| Morning sunlight on arrival in Europe from the US | Lands before body-clock Tmin, delays the clock, worsens the lag | Sunglasses until converted Tmin, bright light 2-3 h after |
| Coaching a loud snorer on bedtime routine | Misses apnea; months lost while AHI stays high | Red Flags first, referral before protocol |
| Treating a night owl teen as an insomniac | Delayed phase + early school start is a clock problem; restriction adds deprivation | Phase-advance protocol (circadian.md), not restriction |
| "Relax and clear your mind" | Sleep-effort paradox: monitoring for sleep prevents it | Stimulus control; paradoxical intention for high performers |
| Adjudicating tracker deep-sleep deficits | Stage data is noise at consumer accuracy | Re-anchor on daytime function and the diary |
Where Experts Disagree
- Blue light: photobiology shows real melatonin delay; behavioral trials show content arousal dominates in adults. Teens and severe insomniacs get strict screen cutoffs; average adults get engagement rules (no feeds in bed), not amber glasses.
- Napping: performance school prescribes it, insomnia school bans it. Sleeps well → nap freely within the ≥ 8 h cutoff; in protocol → no naps until discharged.
- Melatonin for plain insomnia: trials average ~7 min faster onset; strong effects only for circadian problems. Circadian use yes, nightly-forever use no.
- Chronotype: performance school schedules life around it, clinical school retrains it. Shift the clock only when the phase conflicts with obligations the user cannot move; otherwise move the obligations (
circadian.md).
Related Skills
More Clawic skills, get them at https://clawic.com/skills/sleep (install if the user confirms):
fitness— when the lever is training load, overtraining, or workout timing rather than the night itselffasting— when late eating windows or fasting schedules collide with the sleep windowplan— when the fix is calendar surgery, moving deep work to the user's alert hours instead of fixing sleepdreams— dream journaling and pattern exploration; nightmare treatment stays here
Feedback
- If useful, star it: https://clawic.com/skills/sleep
- Latest version: https://clawic.com/skills/sleep
Part of Clawic, the verified skill library. Get this skill: https://clawic.com/skills/sleep.
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