Sleep Restriction Therapy

Sleep restriction therapy is a treatment that is based on the idea that people with insomnia spend too much time in bed. Time spent awake in bed is thought to contribute to subsequent nights of wakefulness, sleep fragmentation, or poor quality sleep. Therefore, treatment is the process of reducing the sleeper’s time in bed to be roughly equivalent to his or her reported sleep time. For example, if a person reports lying in bed for eight hours per night, but sleeps only six hours per night, the sleep restriction therapist might recommend that the sleeper remain in bed for only six hours per night.

The American Academy of Sleep Medicine (a professional organization of doctors) includes sleep restriction therapy as one of its recognized non-pharmaceutical interventions for insomnia.

Sleep restriction therapy usually is administered by a healthcare professional who can tailor the therapy to a patient’s individual needs, but, the basic sleep restriction protocol is:

1. Determine your usual rise time (e.g., 6:30 AM)
2. Determine the average number of hours that you spend asleep in bed (e.g., 5.5 hours) each night. This can be done using a sleep log.
3. Work backwards to determine what your bedtime should be. For example if you normally rise at 6:00 AM and you sleep 5.5 hours each night, your bedtime should be 12:30 AM.
4. Go to bed at your new “prescribed” time each night for one week.
5. If you do not fill your night with sleep, repeat steps 1 – 3 to identify an appropriate, later bedtime.
6. Continue this plan until your time in bed is mostly filled with sleep, or until you reduce your time in bed to 4 hours
7. If you fill your time in bed with sleep, wait for several days and then begin increasing your time in bed each night by 15 minutes. Do this as long as you can continue to fill your time in bed with sleep
8. Avoid hazardous activity if your are sleepy during the day

Depression and sleep restriction therapy

Insomnia and hypersomnia are both common symptoms of depression, even mild depression. Doctors who suspect depression ask patients about their sleeping patterns. Depressed people with insomnia frequently get to sleep in a normal period of time (no unusual sleep latency) but wake after a few hours and pretty much are up for the morning at around 5 am.

Sleep restriction therapy can actually be a short-term treatment for depression. Don't let people sleep as much as they want to, and the depression subsides. It doesn't work for everyone, and it's hardly a long-term cure, but sleep restriction can play a part in overall depression management. Indeed, staying up past one's normal bedtime can often produce a feeling of euphoria.

Sleep Disorders

Dyssomnias

Parsomnias