As a treatment for insomnia, sleep restriction therapy falls under the “behavioral treatment methods”. It also falls under the paradoxical concept of “less is more”. That may sound contradictory to you at first.
A paradox is, in fact, something that seems contradictory on the surface, but once you delve into the subject a bit you find that it makes sense.
Less is More
For example, I’ve been training for a marathon over the last several months. For a period of about six weeks I found that I was getting tireder and tireder, and my legs were aching all the time. I decided I was pushing too hard, so I backed off of my mileage and intensity. Instead of trying to run 70+ mile weeks I was only running 50 or so.
The result? After two weeks the pain went away, my energy picked up and I was able to slowly build the mileage back up to 60/week, and I was running faster. In my case, less running = more benefit.
The reason “less is more” is often true is because we have limited bodies and minds. We are designed to handle excesses for periods of time, but then we must have time to recover. If we eat too much for a few days we will gain weight if we don’t back off and return to a normal diet. If we exercise too long and too hard our bodies will begin to break down, until we back off and allow time to recover.
Similarly, our sleep can become disrupted because of a variety of issues, and the solution may be to back off. Sleep restriction therapy is a way of backing off temporarily and then slowly building back up to a normal level.
How Sleep Restriction Works
Sleep restriction therapy is used as a treatment for insomnia. However, it can be beneficial at other times, too. Whenever your sleep is becoming disrupted, whether you are:
- taking too long to fall asleep initially
- waking up too many times during the night
- struggling to get back to sleep when you do wake up in the night
- not able to get a full night of sleep,
restricting your sleep can be a helpful way to get back on track. Often the tendency of insomnia suffers is to stay in bed longer in the hopes of grabbing as much sleep as possible. This can be counter-productive, as poor sleep associations of frustration can be developed by forcing yourself to stay in bed tossing and turning for hours at a time.
Scientifically speaking, in sleep restriction you are correcting your homeostatic sleep drive, which is one of the two internal biological processes that govern our sleep. The homeostatic sleep drive is like an hourglass. We we wake up we turn the hourglass over so that our sleepiness (the bottom of the hourglass) is empty. Throughout the day the “sandman” gradually adds grains of sleepiness to the bottom. Once the lower chamber of the hourglass is full we are ready for sleep.
For most of us, we need to be awake for about 16 hours for this to happen. Taking a long mid-day nap or sleeping in too late in the morning both make it difficult to sleep at night because they wreak havoc on our homeostatic (hourglass) sleep drive.
This process does require some patience. Depending on how severe your situation you may take a few days or a few weeks to return to normal sleep. Also, it can be a difficult process, at least at first.
The Sleep Restriction Process
Determine how many hours of sleep you are getting per night, and what time you need to get up each morning. For example, let’s say you determine you are lying in bed for several hours a night, but only getting about five hours of actual sleep. Further, lets suppose you need to get up at 6 AM each morning.
Start by only giving yourself five hours in bed. Stay up and stay awake until 1 AM and only allow yourself those five hours to sleep. At first it will be difficult to stay awake and it may be difficult to get even a full five hours. However, after a couple days your body will begin to adapt by making sure it falls asleep quickly and sleeps soundly during that time.
Continue to go to bed at 1 and sleep until 6 until you are able to do so fully. Then, you can begin to gradually add more sleep by going to bed a little earlier. Only add 15-30 minutes at a time, and make an increase as soon as you adapt to the current sleep schedule. In this way you can work your way back to sleeping for 7 1/2 – 8 hours.
If, along the way, you experience difficulty sleeping again, back up and further restrict your sleep for a few nights before progressing.
It is especially important during this process that you not take naps during the day as that will undermine what you are trying to accomplish. Also, make sure you are practicing the best sleep tips and good sleep hygiene.
If All else Fails…
If the above scenario simply will not work for you, there is another option to try. It is essentially do sleep restriction from the other end. In other words, instead of staying awake late, try getting up earlier. Many people find this to be another effective way to correct the homeostatic sleep drive.
Thelonious Monk famously said “Simple ain’t easy”. That is a good description of sleep restriction therapy. It is a simple process of restricting the amount of sleep for a time and gradually building back up to normal sleep. However, it can be very challenging to do it. Those who persevere through the process, though, find that it is an extremely effective way to return to normal sleep.