Trouble staying asleep? Try sleep restriction therapy

Sleep restriction is designed to eliminate prolonged middle of the night awakenings in seven steps.

By Ruthie Darling • October 15, 2019

You’ve tried the warm bath, the milky drink and the lavender pillow spray. But guess what? You’re still having trouble sleeping. If this sounds like you, it might be time to consider another option for your insomnia: sleep restriction therapy. 

Sleep restriction is a cognitive behavioral therapy developed by Arthur Spielman, designed to eliminate prolonged middle-of-the night awakenings. It doesn’t aim to restrict actual sleep time, but rather to initially restrict the time spent in bed.

By limiting the time you spend lying down, a mild sleep deprivation is created that can help with the onset of sleep when you do finally turn in for the night. It’s about consolidating sleep to make it efficient and not a drawn-out and stressful affair. 

Sleep restriction therapy can be as effective as medication in fighting insomnia, and can have a long-lasting impact. However, it can take several weeks of diligent dedication to implement this technique effectively. It’s all about the long game in sleep restriction; don’t expect results immediately, but don’t give up too soon. 

Here are the steps suggested as a program of action:

Step one: Research your ‘sleep number’

In the first week, it’s suggested that you keep a diary of how much sleep you actually manage to get. Not the amount of time you spend in bed, but simply the time you spend sleeping.

Total the number you get in a week and divide it by seven. This is the average amount of total sleep time. Now add 30 minutes to it for a little breathing room. This is your average total sleep time (ATST). The number may be small at first — for example, you may only average 5.5 hours a night — but this can be increased as you move along in the process. 

Step two: Wake time

Decide on a time you need to wake up and stick to this time every morning. Consistency is key in this process, so even if you’ve only been asleep for a few hours, make sure you don’t hit that snooze button even though it may be tempting. Remind yourself that you are in this for the long haul. It will be worth it in the end. 

Step three: Bed time

To determine your bed time, count backwards from your wake time using you ATST from step one. Do not get into bed before your “bed time” even if you feel sleepy. 

Step four: Stick to it

Stick to this schedule for two weeks. If you are feeling good with this amount of sleep and do not feel drowsy during the day, keep going with this method. If you do find yourself feeling tired, add an extra 15 minutes to your bed time. Keep increasing the time in bed at this rate until you feel you are receiving adequate sleep. 

Step five: Use the light

Light can be a powerful controller of the sleep/wake cycle. It’s to do with our inner circadian rhythms. Using a bright light for 30 minutes upon waking can really help firmly reset your body’s inner clock. You can step outside in the sunlight for a half-hour or even use a Lightbox — the type used for those with seasonal affective disorder. In the evening, try to use only dim lights in your home to mimic the natural darkness outside. Install dimmer switches or use candles in your bedroom. 

Step six: No naps!

As much as I hate to say this, napping is a big no-no, at least at this stage. Naps can interfere with your need for sleep later in the day. So, if you can avoid napping, try to add that into the routine. 

Step seven: Sleep hygiene 

Practicing what is known as good “sleep hygiene” can significantly increase your chances of having a good night’s sleep. Sleep hygiene practices include:

·         Avoiding stimulants such as caffeine and nicotine in the afternoon and evening. 

·         Avoiding alcohol. Even though a glass of wine can help you fall asleep fast, it can disrupt your sleep in the second part of the night as the body begins to process the alcohol. 

·         Exercise. As little as 10 minutes of aerobic exercise a day can drastically improve your quality of sleep. Aim to hit the gym earlier in the day though, as exercise can increase energy post-workout. 

·         Avoid spicy or rich foods before bed. No more late night curry or ice-cream parties — these can trigger indigestion and heartburn which is uncomfortable and can wake you up.

Remember that this technique can take several weeks to bear fruit, so stick with it and try to follow all the steps listed above. This therapy is not recommended for everyone so it is important to speak to your doctor before you implement any form of therapy. 

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