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Brandon Peters, M.D.

30 Days to Better Sleep: Go to Bed Only When Sleepy

By January 8, 2013

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After carefully considering the difference between sleepiness and fatigue, you can now make an important choice: go to bed only when sleepy. Among people who suffer from difficulty falling asleep, a common occurrence as part of insomnia, this can be a life-changing decision. It also may defy common practice.

In early life, there is no decision made about when to go to sleep. A sleepy child is soon asleep. When the desire for sleep comes, no matter the timing, it is quickly indulged. As we get older, sleep becomes complicated by our behaviors. We may choose to stay awake, even fight sleepiness, to pursue pastimes. Alternatively, if we have trouble sleeping and feel like we need more sleep, we may go to bed early. We may stop listening to our body's natural cues.

Sleepiness or drowsiness is a cue to get ready to sleep. We should naturally prepare ourselves by settling down into bed. We make ourselves comfortable and, if everything goes to plan, we are soon asleep. In contrast, other descriptions of how we feel - fatigue, tiredness, and exhaustion - may not reflect a desire for sleep if they do not promptly proceed into sleep. Therefore, if we crawl into bed feeling fatigued, this may not result in sleep. Instead, we may be setting ourselves up for insomnia.

People with insomnia often complain of feeling fatigued or tired, but if given the opportunity to sleep, they will struggle mightily. Insomniacs cannot routinely take naps, for instance. If they lie down to rest in the afternoon, they will lie there awake. Insomnia is often described as feeling "tired but wired". Sleep is desperately wanted, but opportunities to sleep are corrupted by wakefulness.

Let's imagine a common scenario that occurs with insomnia and how someone might end up going to bed when he or she doesn't feel sleepy. Insomnia may be provoked by a stressful situation, but it is perpetuated by the resulting changes that are made around sleep. Insomnia is defined as difficulty falling asleep, difficulty staying asleep, or sleep that is not refreshing (in the absence of another sleep disorder). Sleep may become fragmented due to anxiety, with normal awakenings stretching into prolonged wakefulness during the night. By spending several hours awake in the night, it may seem natural to extend the time in bed. Rather than going to bed at 11 PM and getting up at 7 AM, a person with insomnia may go to bed at 10 PM or even 9 PM. In an effort to get more sleep, the time spent in bed is lengthened. However, something inadvertent has happened: this person may now be going to bed when they are less sleepy.

There are two major contributors to the ability to sleep: homeostatic sleep drive and circadian rhythm. The sleep drive is the desire for sleep that builds throughout the day; the longer a person stays awake, the sleepier they become. The circadian timing relates to when we should naturally be awake and asleep, and for humans sleep should occur overnight. (Nocturnal creatures like rats, on the other hand, should be sleeping in the day and awake at night.) By going to bed 1 or 2 hours early, there is less drive to sleep and the timing may be off. As a result, this insomniac may go to bed feeling less sleepy.

As a result, there is a diminished ability to sleep. It would not be unexpected for this person to now have a problem lying awake at the start of the night. By going to bed before sleepiness or drowsiness has developed, the ability to sleep is likewise lost. Similarly, lying awake for prolonged periods in the morning can be detrimental. Even short periods of sleep will diminish the sleep drive and could affect the circadian rhythm.

Therefore, train yourself to go to bed when you are feeling sleepy, not because the clock says it is time to sleep or because you are fatigued. You will find that you fall asleep more easily and sleep better through the night. To help yourself feel more sleepy, you can also work on creating a relaxing buffer zone before bed, a project to commence next.

Check out the entire series, "How to Sleep Better in 30 Days."

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Comments
January 8, 2013 at 7:17 pm
(1) Yan says:

Hi Brandon,

I agree with you. I also believe that sleep disorders can be tempered or cured by a good habit to sleep at the right time. However, because of work, we can not always give us this happiness. Respect the natural cycle of sleep is good advice from a professional that have an excellent practice.

Respectful
Yan

January 21, 2013 at 7:48 am
(2) Guest says:

I enjoy reading through an article that can make people think. Also, thank you for allowing for me to comment!

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