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Brandon Peters, M.D.

30 Days to Better Sleep: Restrict Your Time in Bed, Consolidate Your Sleep

By January 21, 2013

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Our beds can be a place of almost heavenly repose, where we retire at the end of a full day and restore our bodies and minds with sleep. This may not always be the case, however. When the bed becomes a place of turmoil and struggle, the night filled with wakeful anguish, it is not what it could be. If you struggle with insomnia, limiting the amount of time spent in bed may actually help you to sleep better.

Insomnia is characterized by difficulty falling or staying asleep. People with it will often spends hours lying awake in bed at night. Although some light sleep may occur, the desire for sound sleep is diminished by this extended time in bed. It is not uncommon for insomniacs to go to bed early or sleep in as they attempt to maximize the amount of sleep that they get. Unfortunately, this works against the natural systems that contribute to the ability to sleep.

There are two processes that work in combination to promote sleep. The first is the natural timing of sleep called the circadian rhythm. If you try to sleep at the wrong time, as may occur after jet lag, your struggle will increase. The other contribution is homeostatic sleep drive. This is the desire for sleep that builds the longer a person stays awake. This occurs due to the build up of a chemical within the brain called adenosine. By spending more time in bed, especially in light sleep, the sleep drive is diminished.

In order to consolidate your sleep, you should track your sleep patterns with a sleep log. Over 1 to 2 weeks of time, track your typical bedtime, wake time, and the number of hours spent sleeping. Then, to the best you can estimate, calculate your total sleep time. Let's take an example. If you crawl into bed at 10 PM, spend 1 hour falling asleep, spend 2 hours awake in the night, and get up at 6 AM, you would estimate that you got 5 hours of sleep. It is recommended that the nightly total sleep time be averaged over at least 1 week. This way you may have good nights and bad nights without skewing your average too significantly.

Once you have calculated the average amount of sleep that you are getting, you should arrange your bedtime and wake time to reflect these needs. Most people with insomnia will calculate that they are getting between 5 and 7 hours of sleep. There are certainly some who will estimate even less (or none). You should pick your average, but not less than 5 hours. Then consider what your preferred wake time is. If you want to get up at 6 AM and you estimate you are getting 5 hours of sleep based on your numbers, then you do some simple arithmetic. Subtract 5 hours from 6 AM and you have your new bedtime: 1 AM. The suggestion that this be taken as the new bedtime inevitably meets with stern resistance.

Why would sleep experts encourage you to spend even less time in bed when you are struggling to get enough sleep? If your sleep is fragmented, punctuated by awakenings and prolonged periods spent awake, how can you expect to sleep enough to function with less time in bed? Fortunately, you are not the first person to suffer from insomnia and experience and research demonstrates that sleep restriction is a highly effective treatment. In seeking out expertise in this matter, you have reached a point where your insomnia has negatively affected your life. It is time to take the action needed to set things right.

Restricting the time you spend in bed will consolidate the amount of sleep that you get. By staying up late,  you will build up a stronger sleep drive. Therefore, when you crawl into bed, you will be even sleepier. So sleepy, in fact, that you will fall asleep more quickly. In addition, this desire for sleep will keep you asleep during the time that you are in bed. You will then wake up at your desired wake time. You must keep your commitment to the wake time. Set an alarm clock, two if you must, or have someone else wake you. If you have a rough night or two, ride it out: it will get better.

When you start to get reconnected with the feeling of sleepiness (and not fatigue), you may start to add additional time to your total sleep time by going to bed earlier. Do this slowly. You didn't develop insomnia overnight, so don't expect it to be fixed in a few nights. It is probably best to add back 15 minutes every 3 days. Do this until you reach your desired total sleep time. If you calculate your sleep needs, you may stop adding time at 7 or maybe 8 hours. Therefore, if you start at 5 hours, you will have moved your bedtime back sufficiently in about 3 weeks. The best part is that this effective treatment has none of the side effects common to sleeping pills!

If you suffer from insomnia, you can effectively set things right by restricting the time you spend awake in bed. You can consolidate your sleep with a tailored sleep or "time in bed" prescription based on your recent sleep needs. By slowly adding time in bed, you will find that you fall and stay asleep much easier. If you need additional guidance in this process, you can find a cognitive behavioral therapist for insomnia who can ease you through the changes. No matter how you go about it, you will be grateful that you took the initiative to sleep better.

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

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Comments
January 12, 2014 at 10:03 am
(1) Brian says:

I can understand sleep restriction when you have to get up early during for school. When you stay up late and sleep in during the weekends, it’s harder to sleep early for the weekdays. Consistent sleep schedule is certainly important and it’s good to keep your bedroom dark.

Segmented sleep is when you wake up around 2 hours between two 4 hour sleep sessions. It was normal before electricity was invented. It’s nowhere like sleep restriction therapy but some people find it very refreshing. When you have insomnia, self employment is wonderful.
http://en.wikipedia.org/wiki/Segmented_sleep

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