How sleep restriction can improve sleep quality (and duration!) when you have chronic insomnia
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- čas přidán 9. 07. 2020
- If you’re struggling with chronic insomnia, you may have heard of the term “sleep restriction” - now, you might think that you’re already dealing with this since your sleep probably feels quite restricted already!
However, this term refers to an evidence-based behavioral technique that involves spending less time in bed by allotting less time for sleep. This helps to improve sleep quality and, ultimately, sleep duration.
Sleep is a core biological process. It’s something the body always does and our ability to sleep is not something that we can ever lose. If we remain awake for long enough, we will sleep.
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Now, if you’ve lived with insomnia for a long time, you might be asking why sleep drive doesn’t seem to be working for you - why you can be awake for so long during the day and night, and yet still find it hard to fall asleep or sleep through the night. Well, the answer to this can be found in the arousal system since the arousal system is capable of temporarily suppressing sleep.
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Ultimately, the arousal system is a survival mechanism. If you were a caveman and you saw a saber-toothed tiger prowling around outside your cave during the night, you wouldn’t want sleep drive making you fall asleep since you’d probably end up being a nice meal! In this example, the arousal system prevents sleep from happening in order to protect us.
Sleep restriction involves allotting an appropriate amount of time for sleep, based on how much sleep you currently get on an average night, and using this to set yourself an earliest possible bedtime and a consistent final out of bed time. The result is the generation of more sleep drive (this helps overpower the arousal system) and less arousal - because you will start to spend less time awake during the night.
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In effect, the more time we spend in bed asleep rather than awake, the more we associate the bed with sleep rather than wakefulness. When we associate the bed with sleep rather than wakefulness, our brain learns that the bed isn’t a threat and this can further weaken the arousal system.
As the quality of our sleep improves, we usually start to feel better during the day, we start to regain confidence in our natural ability to sleep, we might start to worry a little bit less about sleep - and this is when we often start to see sleep duration increase, even though we started this whole process by allotting less time for sleep.
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My name is Martin Reed and I am the founder of Insomnia Coach®. I offer sleep coaching services that give people with insomnia all the skills and support they need to enjoy better sleep for the rest of their lives. I also offer a free two-week sleep training course for people with insomnia at insomniacoach.com/sleep-train...
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All content found on the Insomnia Coach CZcams channel is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
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All content found on the Insomnia Coach CZcams channel is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. All content is provided “as is” and without warranties, either express or implied.
Ive been dealing with chronic insomnia for about 3 months now. It is the hardest thing I have been through in my entire life. It has made my anxiety spiral out of control which has caused me to be depressed and I have never been a depressed person. Ive been using supplements and anxiety medication to sleep and sometimes it works and sometimes it doesnt. Most nights I feel like i dont sleep at all. I used to sleep 9 hours a night and be able to sleep for however long I wanted to! I realize that I have to stop caring about the sleep efforts and thoughts but they consume my mind on a daily basis and its extremely annoying and frustrating. I tend to overthink things which is ultimately making this worse and I keep feeling like my lack of sleep is going to end up killing me which scares the hell out of me because I have always been a health conscious person which contributes to my anxiety. I wanted to try your course Martin but it is rather expensive and Im somewhat skeptical about it...
I understand your skepticism, Branden - I am sure you have tried many things in a bid to improve your sleep, and my coaching services might seem like yet something else that offers promise but might let you down. I'd suggest listening to some success stories over on the Insomnia Coach Podcast - if you can identify with my guests, you might consider that what they did to improve their sleep might work for you, too. Here's a link to the podcast episodes on CZcams: czcams.com/play/PLzlNKjoB23Ll7PSEJHquZjx4QSbZAtQy9.html
Hai do you still have chronic insomnia?
Chronic insomnia ain’t chronic until 3 months.
You’re videos are so helpful. Thankyou
I appreciate you sharing that - thank you, Gabriella!
Martin, cheers for this valuable information, I’ve been struggling with insomnia for over a month which in turn developed bad anxiety. I will definitely be putting sleep restriction in to practice as the more I think about it the more it makes sense. Thanks again from over in the 🇬🇧
You explained it so well. And I’ve been researching this for years.
I appreciate you sharing that with me. Thank you!
Very helpful.
Thanks for sharing!
Thank you Sir
You are most welcome!
Thanks!
You're welcome - thank you for your support!
Thank you so much for this information Martin, very well presented, easily understood, and gratefully received!
You're welcome, Denis - thanks for taking the time to share your feedback!
Very logical to implement. thank you so much
You are welcome!
You have changed my life forever thank you
You changed your life, Eva! I merely provided information! What did you start doing differently to change your life forever?
Hi Martin, I find your videos really helpful! Thank you so much! Regarding getting up at the same time every day - what I am uncertain about is whether I still should get up when. I am about to go back to sleep. I tend to sleep 2-3 hrs, then awake for a couple of hours and then fall asleep for another couple of hours. Using the technique of restricting time, that is the time when I should get up. So should I set an alarm to wake me up at the same time every day even though I just fell asleep? If so, that means I allow myself to sleep 2-3 hrs/day and that’s hugely effecting me during the day at work, especially if it is repeated day after day. I went though that already. Just started a new job, so going through a lot of training where I have to retain information which I find nearly impossible without sleep. I am also studying which is also really challenging without sleep. The sleep issue is giving me huge anxiety, because I feel I am struggling in both areas which I feel is hugely contributing to my sleep issues. Feels like. viscous circle. Could you please clarify regarding the wake up time?
An alarm can be really helpful - it might lead to a bit less sleep on those occasions when you feel you might be able to get a bit more sleep if you were to stay in bed. However, what's your goal? Is it better sleep on those days, or is your goal better sleep for the rest of your life? If it's the latter, it might be worth sacrificing a bit of sleep in the short term to improve sleep and enjoy more consistent sleep over the long term!
Hey! You look like Jean Claude Van Damme. I loved your contente! New subscriber!👏👏👏
Jean Claude?! I'll take it! Glad to hear you're enjoying the content and thanks for subscribing!
@@InsomniaCoach thank you!
Martin, once again, thank you for all these helpful and reassuring videos!
I have a question concerning the sleep related anxiety that kicks in every evening roughly at 8pm! I may spend the whole day enjoying my activities, but once I come back home or once the evening/darkness approaches, that's when the worry begins.
Does it mean that stimulus control is not too strong yet?
What should I do with this 8pm anxiety every evening?
Thank you!
If your mind is generating worry and anxiety, we know that you are a human being who experiences the full range of human emotions. We also know that your brain is doing what it's programmed to do - look out for you! Unfortunately, sometimes our brain can be a bit over-enthusiastic as it tries a bit too hard to look out for us - but its intentions are good! I think acknowledging and making some space for worry and anxiety can be a helpful strategy - even though these emotions can feel unpleasant, we are usually safe when we experience them, and we are always able to choose how we respond to them.
i'm going to start this tonight! i've been dealing with horrible insomnia for the past 2 months and i'm going crazy and i do not want to be dependent on any drug or pill, i want my own natural sleep back😩😩😩 i really hope this works 😭
Thanks for sharing that you are starting on the journey toward creating better conditions for sleep! Please share an update in a few weeks and let us know how you're doing!
How do you feel now ?
@@luisvenegas5308 hi! thankfully my insomnia had gotten better using the techniques...i still struggle at times to fall asleep and i also still toss and turn during the night but i try to wake up consistently at the same time despite when i go to bed. i've kinda slacked on the blue blocking glasses at night and screen time restriction, but overall i am doing very well, thank you for checking in with me😬
@@cocosiz any progress ?
@@HereComesTheSmartAlec hi there. i find that the insomnia comes and goes-sometimes around my cycle and also randomly. i try to practice your advice and also just accept that i might not get sleep and that's ok bc i will get better
How do I set a window if I take hours to fall asleep eventually at 5am and only sleep an hour or two? I’m implementing getting out of bed after 30 mins if not tired..
Thank you coach..i always cry because im afraid if i can still back my sleeping system.i cant sleep for 3 day..how i wish you could help me.im 4 months having this insomia..
There's no need to be afraid of insomnia, Reno! Sleep drive will always make sleep happen in the end - no matter how anxious or scared we are, when we have been awake for long enough we will always sleep. The body will always generate - at the very least - the minimum amount of sleep you need. If you have been diagnosed with chronic insomnia, it might be worth looking into cognitive behavioral therapy for insomnia (CBT-I).
I have yet to start sleep restriction since insomnia is a new problem of mine for over a month now. I typically average probably 4-6 hours of broken sleep throughout the night. I don't have a problem falling asleep all that much but I rarely sleep more than 2 hours at a time. I typically go to bed around 9:30 and get out of bed at 6-7 in the morning. I feel terrible in the morning most days. What do you think I should set for my sleep window? Thanks for the video, great stuff.
It does sound as though you're spending a lot of time in bed - up to nine-and-a-half hours based on the numbers you shared! You might want to start with a sleep window of around six hours and see how you do with that after a couple of weeks!
Thank you for the video! I definitely need to try this. One question: How to spend all this time out of bed when not having to work. Would it be ok sit down on a sofa, watch a movie, read a book etc. or would this be too much a hanging around, like spending time in bed?
I am spending a lot of time on my bed when coming home from work, relaxing. This might be the worst to build a sleep drive, right? Would sitting on the couch make a difference or should I force myself to be really active during waking hours? No sitting down and relaxing, if possible?
You can do whatever you like when awake! Sleep drive is related more to the amount of time we spend awake rather than our activity levels. With that being said, the less active we are, the more fatigued/lethargic we can feel - and the less sleep we might need (and generate), too!
Hi Martin. I have trouble sleeping for about 5-6 weeks. Some nights I can manage to sleep as long as seven hours and Some nights I don't sleep at all. I usually sleep on the couch cause the bed makes me more anxious. Insomnia has a great effect in my daily life. Should I start implementing cbt-i techniques like sleep restriction and stimulus control or you think is to early; I think that my problem want resolve and I must do something about it!
This is, of course, completely up to you! You might find it helpful to start by reducing the amount of time you allot for sleep so you have less opportunity for extended periods of nighttime wakefulness while also building sleep drive. It might also be helpful to avoid sleeping on the couch since sleeping on the couch can train the mind to associate the couch with sleep, rather than the bed!
This is what ı had red in doctor Viktor franklyn's book.he advice his patiens to struggle for not to sleep instead of to sleep..
I wake up in the middle of the night regularly between 2:30-3:00 AM. I have no problem falling asleep initially or falling asleep after the mid-night wakening. Although I do go the bathroom, I don't believe that causes me to wake up. Would CPT-i be helpful ( I tried it once in the past with very little success at a university sleep department) or some other approach? Thanks.
It's impossible to say for sure without knowing more! However, I can say that CBT-I is helpful for insomnia characterized by difficulty falling asleep and/or difficulty with waking during the night and finding it hard to fall asleep because CBT-I techniques strengthen sleep drive, strengthen the body clock, and lower arousal. I hope this helps!
Hi Martin, I stared my sleeping window (5.5 hours) this week and last night was the third night and today I feel so tired and without energy because I slept between 3.5 to 4 hours, How long takes to see the results with sleep restrictions ?
Everyone is different, Edwin. In my experience, many people first notice heightened sleepiness as bedtime approaches, followed by faster sleep onset, and finally more consolidated sleep. Everyone has their own timeline, though!
What if you’re not sleeping at all during the night?
Hey Martin, just wondering what happens if you are so sleepy before your sleep window starts and you sit down to watch tv and pass out but only sleep max 30 mins before being jolted awake again and when you wake up you have lost that super sleepy feeling and can't fall back asleep for the rest of the night or have a night filled with paradoxical insomnia type sleep. I often can fall asleep initially because I'm so sleepy but that sleep doesnt last long at all anywhere from 10mins to half an hour and then I'm awake for most of the night and can't tell many times if I'm awake or asleep.
maybe you can clarify a bit on how i should start, i usually go to sleep around 1:30am and i used to fall asleep fairly easy but now i'm tossing and turning or just awake and then at 3:30 i end up taking some pill to sleep then wait for it to kick in till 4 something, then have broken sleep waking almost every hour till 9am which is my planned wake up time. should i start to restrict to 5 hours so just go to bed at 4am? i have an app with sleep specialist next week but this has been driving me crazy and making me very hopeless and depressed!
I don't usually suggest allotting less than around five-and-a-half hours for sleep. You might want to explore whether having a pill available during the night might be increasing arousal through the mental gymnastics caused by wondering whether/when/if you should take it and, in turn, making sleep more difficult. Sometimes it can be more helpful to eliminate this question by just taking a pill at the start of the night, or choosing in advance if tonight will be a pill night or not. If you are referring to prescription medication, changes should be discussed with your doctor first. More information on sleep restriction, along with a sleep window calculator, can be found here: insomniacoach.com/sleep-restriction-therapy/
I have had chronic insomnia for a year. I tried implementing sleep restriction during the last week but I have started having more nights where I am awake all night (no sleep) then end up crashing the second night before my alloted sleep window due to exhaustion and sleeping past my wake up time. How do I stay awake after 24 hours of no sleep so I can go to bed at the correct time the next night? Any advice would be greatly appreciated. I really want sleep restriction to work.
Staying awake can be a real challenge (ironically, since before the big challenge was falling asleep)! Often, movement is the most helpful thing to do - when we are moving and engaged in a task, it's harder to fall asleep.
Hi, if u sleep 1 night for 8 hours but another for only 1 hour followed by another 8 hours. What should you do? Because this is causing me excessive anxiety
Usually, those big swings occur if we are allotting too much time for sleep/spending too much time in bed. Here's a video about this: How to stop the sleep roller coaster and make sleep more consistent and more predictable - czcams.com/video/86qD_SFPd24/video.html
Right now I’m averaging 2 hours per night of sleep. Last night I went to bed at 11pm but didn’t fall asleep until 3am and woke up at 5am. I tried to sleep again but anxiety was too high. What should my sleep window look like? And is 2 hours per night dangerous?
To come up with a sleep window I usually suggest adding 30 minutes to your average nightly sleep duration taken over the past week or two. If your average nightly sleep duration is less than five hours, an initial sleep window of five-and-a-half or six hours might be appropriate. As long as you are giving yourself the opportunity to get enough sleep, you aren't depriving yourself of sleep - here's a video on the differences between chronic insomnia and sleep deprivation: czcams.com/video/_dPWDYW-YgE/video.html
i am doing my sleep restriction therapy this week i had a 6 hour window for seven straight nights i had good quality sleep for about 5 hours 50 minutes but last night i had a rough night took me 2 hours to get to sleep and kept waking up several times during the night, so should i add 15 minutes to my window or should i keep it the same ?
If you experienced seven straight nights of 5 hours and 50 minutes sleep with a 6 hour sleep window, this means your sleep efficiency was 97%! Since difficult nights from time to time are normal and to be expected, I wouldn't suggest letting one difficult night distract you from the seven straight nights of great sleep you got! So, if you feel comfortable and confident doing so, feel free to add those 15 minutes onto your sleep window! Stick to the new window for at least a week and re-evaluate from there!
yes, thankyou sir, i will do exactly what you are recommending, going to add 15 minutes and stick to it for a week.
@@InsomniaCoachHi Martin, thank you very much for being around answering all the questions!
I have a similar question about a sleep window. The last week (my second week of SR) I averaged to ~5.5 hours with a ~6.20hour sleep window (last three nights were great with a 97% efficiency). But the problem is every evening is becoming more and more difficult waiting until my window opens, to the point that I'm becoming anxious and irritated struggling to sit and count minutes (at this time I'm unable to read anymore as my eyes are sore and heavy). Last night I got so tired of waiting that I went 15 minutes earlier, being anxious about it I couldn't fall asleep again despite the fact it wasn't a problem anymore for the last week.
What should I do in this case? Should I start going to bed 15mins earlier now (my sleep efficiency yields ~85.5%) or should I stick to a previous window a little longer and struggle a little longer? I usually start feeling sleepy at 11pm, just an hour before my window opens.
Also, the bad night after a row of good nights is so frustrating :( (but I know now it is a normal part of the game). Thank you for all your suggestions!
@@TheAduos I think this video might help (do let me know your thoughts): If you plan to go to bed later at night, is it OK to go to bed earlier if you feel sleepy enough? czcams.com/video/-rD-0Zm_hOo/video.html
the week i kept my sleep window to 6 hours i had great nights for 7 straight days of about 5 hours,next week i added 15 minutes to my window and things got bad .. average sleep gone down to 5 hours 15 minutes and out of 7 days 2 nights went really bad, so today i am starting the week with 5 hours 15 minutes window..am i on right track ?
Did you stick with the new sleep window for at least a week? I wouldn't usually suggest a sleep window of 5 hours and 15 minutes since that's quite short. If adding 15 minutes didn't prove helpful, I would usually suggest simply taking the 15 minutes back off and reassessing after a week or two.
@@InsomniaCoach yes, i did stick to the new 6 hours 15 minutes window for a week, now i am doing a 5 hour 30 minutes window,but you were right though .. just subtracting 15 minutes from my window was the rational thing to do, but i started this week with 5 and half hour window, the week is going well so far..
What if I experience one night of decent sleep and then the next night of 0 sleep ? I get up exhausted. I often give up on sleep restriction then. Should I restart again ?
What a great question! Typically, you want to stick with your chosen sleep window regardless of how you sleep from night to night. Here's an overview that you might find helpful: insomniacoach.com/sleep-restriction-therapy/
I have same thing going on.my window for this 11 pm to 7 am
I usually struggle the most going on holiday , sleeping at new places or sharing a bed. How do I overcome this?
I wonder if actively trying to overcome it might be the cause of the struggle? Perhaps going on holiday and living the kind of life you want to live is more important than how you sleep when in new places?
@@InsomniaCoach It is more important but I struggle to handle my emotions when I don't sleep much and my anxiety can get bad, have you got any tools I can use or advice on how to stay calm
@@gabriellahardy6636 If only there was a magic switch we could flip to control our thoughts and emotions! Unfortunately, there isn't! For as long as we are human, we will experience the full range of human thoughts, feelings, and emotions. Some will feel good and some will not. It's when we try to fight these things that we tend to get tangled up in an endless (and exhausting) struggle. Sometimes it can be helpful to make space for the difficult stuff to exist - if we do that, we free up a lot of energy to do things that truly matter. And, when we do that, these difficult thoughts and feelings tend to come and go, rather than continue to push back even harder as we try to push them away. I hope this helps!
Does this same approach apply to young children? My 9 year old appears tired, but then take 30mins to drift off each night
Young children don't usually exhibit the thoughts and behaviors that perpetuate sleep disruption in those with chronic insomnia, so I wouldn't suggest these techniques for young children.
I don't think there's anything particularly unusual with it taking a nine-year-old 30 minutes or so to drift off to sleep each night. As a father, I can tell you that sometimes it takes my five-year-old even longer to settle down after lights out!
@@InsomniaCoach thanks Martin
@@tacs_01 You're welcome!
Can I set 6 hour sleep window if my average sleep duration is 5 hour calculated over week ?
Sure! If you want to really intensify that sleep drive you might even consider an initial sleep window of 5.5 hours!
@@InsomniaCoach I have one more question regarding Stimulus Control. If I feel relax on bed, do I still need to jump out of bed after every 20 minutes ?
@@akashverma5756 If being in bed feels good, conditions are right for sleep - so usually there's no need to jump out of bed!
Hi Martin. I started Sleep Restriction this week and it’s making my sleep worse after dealing with insomnia for 5 months. I struggle with sleep onset and sleep maintenance and get out of bed when I can’t sleep (30 min-1 hour) and only return when I feel sleepy and get out of bed at same time each morning. Unfortunately, my total hours of sleep has diminished from 4.5 hours four night ago to barely 1 hour last night. I keep waiting for my sleep drive to override but it’s not happening. This is only hurting my confidence and making my anxiety/arousal worse. Is this normal??
Good on you for starting with sleep restriction to reduce the opportunity for extended wakefulness and to build sleep drive! It's not unusual for sleep to temporarily get worse since you are implementing something new and the brain likes to monitor for the outcome of anything "new"! The first couple of weeks are often the most challenging, but sleep drive ALWAYS wins in the end - if you only allow yourself to sleep during your sleep window, that is when you WILL start to sleep!
@@InsomniaCoach thanks Martin. My docs were strongly suggesting SSRIs to help with my anxiety during sleep but I’m really trying to avoid medicine. Thanks for your encouraging words. I think I’m already starting to see some small improvements
@@mausmipatel1196 This is great to hear, Mausmi! You are starting to see some small improvements because you carried on and gave yourself the opportunity to enjoy some small improvements! Those improvements are also evidence of your natural ability to sleep and prove that your efforts are worth it!
@@mausmipatel1196 are you doing better now?
@@AMJSKATESHOP yes! I am taking an antidepressant which really kicked in around the 2 month mark. I also go to bed with the idea that “it’s okay if I don’t sleep”- this has been life changing. It’s simple but it’s been the most effective mindset change I’ve done
I feel like you just pandering to insomniacs