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Sleep Restriction Therapy: When Nothing Else Works

So you’ve tried all the ‘better sleep tips;’ seen a doctor, dieted, exercised, excluded caffeine and bad foods etc, and nothing seems to really help you with your sleep disorder? If so, don’t lose hope. Researchers are learning new and effective ways to help us regain those few precious hours and even minutes of sleep. One of these most effective treatments is called Sleep Restriction Therapy.

Dr. Spielman at Columbia Presbyterian in New York may have pioneered a new, effective treatment called sleep restriction therapy. Within a month, his insomniacs were sleeping a good seven hours, and they reported that the quality of their sleep was much improved.

Retraining Your Body

Sleep Restriction Therapy, also called sleep deprivation therapy, is based on the idea that your body has learned how to get along without sleep. Whether this was caused by circadian rhythms, trauma or bad habits when you were young, good evidence shows that you can retrain your body to sleep again. The bad news: It’s not easy and it takes a few weeks. The good news: You’ve probably suffered worse, and it only takes a few weeks.

The Downside of Sleeping Pills

One of the hardest things you may have to do before trying sleep restriction therapy is make sure you’re off sleeping pills. If you’ve been on sleeping pills before, you know they don’t really help with long term sleep problems, they don’t increase sleep duration, and they are highly addictive. “The only effect sleeping pills have,” says sleep expert Dr. Kripke at UCSD, “is they make you feel good about not being able to sleep.” Sleeping pills will harm any chance of retraining your body to know when to sleep and how to stay asleep.

Step 1: Find your minimum sleep threshold

Almost all of us can get a little bit of sleep each night, even if it is for only a few hours. Use the mood tracker to keep a daily log of your sleep times. The mood tracker is also great for identifying foods, activities or events that disrupt sleep. Once you have determined the average minimum amount of time you are able to sleep, move to step 2.*

Step 2: Go without sleep all day

Using sleep restriction therapy and thereby depriving your body of sleep for a 24-hour period, your body builds up endogenous sleep inducing chemicals that increase your desire and ability to sleep. Staying completely awake also disrupts your ‘learned’ sleep cycle, and is similar to holding down the restart button on your computer. Sleep fasting reboots your internal sleep computer.

Step 3: Use your minimum sleep time to allow yourself to sleep

Only sleep for that amount of time, even if you could sleep in more. Also, subtract the time you are able to sleep from the time you usually wake up or want to get up, and set this as your subjective bedtime. For example, if you wake up at 6:00am, and your minimum sleep threshold is 3 hours, then stay awake until 3:00 am before going to sleep. Remember to get up at 6:00 even though you may want to sleep in.

Step 4: Use specialized bright light to reinforce your new wake schedule

This is one of the most important steps to sleep restriction therapy. Bright light is the most powerful regulator of the sleep wake cycle. Using light will help reset a normal sleep/wake pattern, and trying sleep deprivation therapy without bright light is not nearly as successful. Using light for approximately ½ hour upon awakening is sufficient to regulate the sleep/wake cycle.

Step 5: Gradually increase minimum sleep threshold

This is one of the most important steps, because if you jump back too quickly into trying to sleep all night, you’ll lose any benefit you gained up to this point. The idea here is to only add 15 minutes of sleep per night until you start having trouble sleeping again. For example, on night one, you go to sleep at 3:00 am and get up at 6:00 am. Night two, you go to sleep at 2:45 am and get up again at 6:00 am (Always keep the same waking schedule). Let’s say that by night six, you’re going to sleep at 1:30, but now you start having trouble sleeping. Go back to where you are able to sleep solid and stay there a few days before trying to add more time.

Step 6: Don’t nap!

Napping can disrupt your circadian rhythm and hurt your ability to sleep again when you need to. When you nap during the day, you teach your body to sleep when it shouldn’t, and then it can’t sleep when you really need to. If you suffer from chronic insomnia, you should never try to nap again, it’s that important. If you feel tired during the day, use your light box or get out in the sunshine and exercise until the drowsiness is gone, but don’t give in to napping.

Sleep restriction therapy works with most chronic sleep suffers. It may not bring back the elusive 8 hours of sleep but it will most likely add a couple of hours of needed sleep. As one sleep sufferer said, “If I could even get another half hour, that would be paradise.” Remember, as with all disorders, you should talk with your doctor or sleep specialist when considering any treatment.

* In Dr. Spielman’s studies, most people found that five hours was the average acceptable minimum sleep time.

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Comments (22)

  1. I’m trying this method out as nothing else has worked. Is it okay to take a small dose of melatonin to help initiate sleep onset each night?
    Thank you so much

    • I would love to sleep with out sleeping pills. recently, my dr put me on ambien. i was on restoril for about 5 years,. on both medication i only sleep for about 4 5 hours and i feel refresh. i have to try something other than pills. they say there is something wrong with it . and you know. i don’t care. i need sleep even if its for 3-4 hours.

    • You can allow your body produce it’s melatonin by using orange glasses 3 hour prior bedtime. Blue light avoid your pineal gland to produce melatonin. It’s a natural solution, better than swallow synthetic melatonin that can disrupt your body hormonal system.

  2. Have been trying sleep restriction for almost 4 weeks now (only giving myself 5.5 hours in bed) and while I can usually sleep for 4 hours at a time (this is an improvement), I have yet to have more than a couple 5 hour nights in a row. How long do you think I should keep going before going to bed earlier? I am afraid to start adding time because I might go backwards in my progress. I am also wondering if it makes sense to further restrict my time in bed? Bottom line I want to know how long this is supposed to take?

  3. I think my insomnia started by taking flomax
    One of the side effect is insomnia.
    I stopped flomax but sleep problem continues.
    Now i am wondering can flomax really cause chronic insomnia?
    I also cant sleep past 6am.

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  13. i am trying this system started by staying up last fri all night and 5 hrs was my starting point getting up is very difficult

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  15. Try two weeks without milk, I’m about to do it, because (in infants) milk allergy can be a cause for very bad sleep patterns. It takes between a week and two weeks to get it out of your system, though.

  16. I cant sleep properly but it started just before few weeks.. when I start to sleep I am thinking too much.. my thuoghts become diffrent.. I dont like noise light when am ready to sleep…

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