Some insomnia sufferers who visit my website head straight for the posts on sleep restriction. So I decided to create a video trailer where I could talk about my own experience of sleep restriction: how off-putting the idea was at first, and the results I later achieved.

I posted the video on Facebook last week and got an interesting comment from a friend (who does not have insomnia himself). To him, the idea of restricting sleep time, and then increasing it bit by bit, did not sound counterintuitive at all. He compared it to the building of strength and dexterity that occurs with physical training, and the development of musical ability that occurs with daily practice on an instrument. The idea of improving sleep through the disciplined restriction of time in bed sounded perfectly reasonable to him.

There’s logic in what he says. Yet to those of us with insomnia, sleep restriction can sound daunting and downright scary. We know what it’s like to struggle with the daytime symptoms of insomnia: the fatigue, mood swings, and days when we can’t put two and two together or remember names. Why choose to subject ourselves to a treatment that involves slogging through a period when our symptoms may get worse?

Yet my own experience—and the experience of other insomniacs I went through group therapy with—suggests the bad days are numbered. By the second week we were already noticing improvements in our sleep and daytime stamina. Some of us found relief even sooner. Watch the video and see if you’re convinced.

As usual, I’d love to hear your comments.

Posted by Lois Maharg, The Savvy Insomniac

Lois Maharg has worked with language for many years. She taught ESL, coauthored two textbooks, and then became a reporter, writing about health, education, government, Latino affairs, and food. Her lifelong struggle with insomnia and interest in investigative reporting motivated her to write a book, The Savvy Insomniac: A Personal Journey through Science to Better Sleep. She now freelances as an editor and copy writer at On the Mark Editing.

192 Comments

  1. Yep, good stuff. SR works. The concept of spending less time in bed awake is crucial I think, and SR and Stim Control work synergistically to accomplish this. It takes effort and will power as you know.

    BTW I just started your book – wow you did a ton of research! I’m sure I’ll be recommending it to my patients and friends. Thanks Lois.

    Michael

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  2. Hi Michael,

    For people who’ve struggled with insomnia for many years, the idea of sleep restriction can sound so wrong. I’ve talked to some who say it sounds too difficult, like too much work.

    But if you put any stock in scientific research (and I’m sure if you’re reading my book that you can tell that I do!), it’s hard to dismiss sleep restriction and other behavioral treatments for insomnia. When there’s a success rate of 70 to 80 percent, you have figure there might be something to it.

    Yes, I did a ton of research! But for me it was a labor of love, something I felt driven to do because insomnia was such a constant and unwelcome companion for so many years.

    Anyway, I’ll be very interested to hear what you think of the book when you’re finished. Thanks for the vote of confidence!

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    1. Hi,Lois. I hope you will see my comment. I developed terrible insomnia after withdrawing from adderal and ecstasy. The third week of withdrawal I developed insomnia. I only took adderal and ecstasy one time and this happened to me. I did take a high dose of adderal. Anyway 7months later I still am not sleeping more than a hour sometimes 2 a day. And I fall asleep without fail at 6am or 7am. I simply can’t sleep at night. Anyway I tried sleep restriction for 5days and getting sun therapy and I started being able to sleep much better. I’m not sure if its because of the sleep restriction n sun therapy but that’s all I was doing at the time. Anyway I stopped doing SR n sun therapy since I noticed I was sleeping 5hrs now. I was happy and thought I was fixed well I slept fine for 4days and the insomnia of sleeping at 6am only came back. Now I am trying SR again. I go to bed at 11and wake up at 7-25am. Can you give me some advice I’m not sure what is the best time for me to lay down and wake up. Any advice please? I’m desperately seeking sleep.

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      1. Hello Tonia,

        Apologies for not responding sooner. I’ve had a really hectic week.

        I think that in your situation, I’d want to see a doctor, and the sooner, the better. For one thing, you need a diagnosis before you can know for sure if sleep restriction therapy is an appropriate treatment for what you’ve got.

        In some ways, it sounds you might be dealing with delayed sleep phase disorder (DSPD), in which case sleep restriction wouldn’t be helpful. Instead, bright light therapy and a melatonin supplement would probably be prescribed. Here are a couple blog posts you might find helpful:

        https://thesavvyinsomniac.com/q-a-solutions-for-sleepy-night-owls/

        https://thesavvyinsomniac.com/qa-should-night-owls-use-sleeping-pills/

        DSPD may not be the problem you have, however. If the doctor says you’ve got insomnia disorder, then sleep restriction would probably help. Before you try it, though, you need to either find a sleep therapist who can guide you through it or do some serious reading about the process on your own.

        I’ve written a bunch of blogs about it, and some of them might be helpful:

        https://thesavvyinsomniac.com/be-your-own-sleep-scientist/
        https://thesavvyinsomniac.com/sleep-restriction-in-a-nutshell/
        https://thesavvyinsomniac.com/qa-sleep-efficiently-for-a-better-nights-rest/
        https://thesavvyinsomniac.com/q-a-is-sleep-restriction-as-bad-as-it-sounds/
        https://thesavvyinsomniac.com/sleep-restriction-what-you-need-to-succeed/
        https://thesavvyinsomniac.com/qa-sleep-restriction-tempted-to-give-up/
        https://thesavvyinsomniac.com/qa-during-cbt-do-i-have-to-stop-my-sleep-meds/
        https://thesavvyinsomniac.com/managing-anxious-thoughts-at-night/
        https://thesavvyinsomniac.com/pre-sleep-activities-for-the-sleepless/
        https://thesavvyinsomniac.com/ease-insomnia-by-changing-negative-thoughts

        I devote a whole chapter to cognitive behavioral therapy and sleep restriction in my book, THE SAVVY INSOMNIAC.

        There are good resources online such as Sleepio and SHUTi. You might also be able to find books at the library: The Insomnia Workbook is a good one, as is The Insomnia Answer.

        Good luck, Tonia, in getting the help you need.

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    2. I have been waking after 2.5 hrs of sleep and many times cannot go back to sleep. If I can get between 5 to 6 hrs of sleep, then I am fined with other. Any suggestions will help

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      1. I restricted my sleep to 1am To 6am. I did sleep 5 hrs 3 nights in a row. However, last two nights, I slept in fragments. Should I restrict to 4 hours for a week?

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      2. Hello Kamal,

        Sleep restriction is a process that goes somewhat slowly. You keep a sleep diary throughout the process. If you found, after keeping the sleep diary for a week, that you were averaging 5 hours of sleep or less a night, you set your sleep window at 5 hours a night and continue with that 5-hour sleep window for one week. At the end of the week, you calculate your sleep efficiency. Based on your sleep efficiency, you set your sleep window for the following week. This blog post discusses how to make that calculation and how to make adjustments to your sleep window at the end of the week.

        https://thesavvyinsomniac.com/qa-sleep-efficiently-for-a-better-nights-rest/

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    3. Hi lois, thanks for writing this article, I really hope you can give me some advice. I’m 14 years old and have not been able to get restful sleep for more than a month.I’ve been to doctors who have told me to practice sleep hygeine , which I have, but nothing seems to work. I wake up about 2 times a night, and sometimes don’t even fall asleep. I went through stress, but even though now I feel my mind is mostly at rest, my sleep has not been improving. I get about 4 hours of sleep a night. I was wondering if you have any advice, and if you think sleep restriction would be something to consider at my age, thank you.

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      1. Hi Alex,

        I’m very sorry to hear you’re having such trouble getting a good night’s sleep. I haven’t studied sleep problems in people your age. And some doctors don’t seem to take complaints about sleep very seriously—no matter how old their patients are.

        But there are pediatric sleep specialists who I’m sure would be able to help you. I wonder if your mom or dad could help you find a specialist in the area where you live?

        I wish I could be more helpful. Keep pursuing this until you find the help you need, and good luck.

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  3. While I have yet to read this book I would love to hear how long you think that sleep restriction should take? I am almost through my 4th week of giving myself 5.5 hours of sleep and while I am now mostly sleeping for 4 hours at a time I have not had more than 2 nights in a row of getting 5 hours at a time. I am exhausted and would love to go to bed earlier but I don’t want to add time and then have to go back if it doesn’t work.

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  4. Hi Jamaica,

    I’m sorry to hear this process is dragging on so long! But there may be a way to move it along faster.

    The thing I’m wondering about is this: how did you arrive at 5.5 hours in bed as the appropriate place to start? If right now you’re sleeping just 4 hours a night, allowing yourself 5.5 hours in bed may not get you where you want to be. You’re not restricting yourself to the point where sleep drive can build up high enough to put you to sleep quickly and enable you to sleep through the night.

    To get this therapy to work, in the first week, you’ve got to restrict your hours in bed to the hours you’re actually sleeping. In your case that would be 4 hours a night–which sounds like very little time in bed! Restricting yourself to just 4 hours in bed may not be such a good idea.

    In cases like yours, some sleep therapists recommend starting at 5 hours in bed. Others say it’s OK to start at 4.5. Either way, restricting your time in bed a little more should enable the build-up of more sleep drive, which will move the process along more quickly.

    Just as an FYI, by keeping a sleep diary I found out I was sleeping an average of 4 hours and 45 minutes a night. So during the first week of sleep restriction, I stayed up till 12:15 and got out of bed at 5. The first 3 nights I hardly slept at all. But on the 4th night, things started to change.

    If you restrict your time in bed a bit more, you should begin to notice you’re dropping off more quickly and sleeping more soundly by the end of the second week.

    Let me know if it works!

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  5. Hi. I am just now on my 4th week of sleep restriction. The first couple weeks I saw major improvements, but week 3 and 4 have been rough.

    You said sleep restriction has between a 70-80% success rate. I was just curious if you know what might account for the 20-30% failure rate? Are there certain trends amongst that group or are some people simply not “curable”?

    Thanks.

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  6. Hi Christine,

    I haven’t seen anything more than speculation from sleep specialists about why 20 to 30 percent of the insomnia sufferers who try sleep restriction aren’t able to benefit. But here’s the essence of that speculation.

    Sleep restriction enables the build-up of sleep drive. With enough sleep drive, you should be able to fall asleep fairly quickly and sleep through the night.

    Insufficient sleep drive is believed to be one cause of insomnia, particularly in people with “psychophysiologic insomnia.” That’s the most common insomnia diagnosis. The symptoms are these: feeling physically wound up, feeling anxious about sleep, nodding off at unusual times & places, and being prone to intrusive thoughts & rumination. If these are your symptoms, the expectation would be that sleep restriction could help.

    I’ve heard some experts wonder if insomniacs who don’t benefit from sleep restriction are actually complying with the rules of treatment. SR is very demanding, as you seem to know! The suspicion is that some patients are “cheating.” How much or what kind of information this concern is based on, I don’t know.

    Another speculation is that sleep restriction may not work well for people diagnosed with “paradoxical insomnia.” That’s a diagnosis that would only be given based on a sleep study. A person goes in claiming that she’s sleeping just 1 or 2 hours a night, but her EEG suggests she’s sleeping a full 7 or 8 hours. (This isn’t just a problem of “misperception,” by the way. There may be brain activity that the sleep study simply isn’t picking up on.) Sleep restriction in this case might not be an effective therapy, or so I’ve heard it said.

    Another diagnosis for which sleep restriction might not work so well is “idiopathic insomnia.” That’s a diagnosis given to people whose problems sleeping date back to childhood and are suspected to have a strong biological component.

    But these diagnoses are not mutually exclusive (and there are other insomnia diagnoses as well). I’ll keep looking for more information on those 20 to 30 percent who aren’t able to benefit from SR. For now, this is as far as I can go.

    A question for you: you said you improved quite a lot in the first two weeks of SR, but that weeks 3 & 4 have been rough. By any chance has your life gotten more stressful in the last couple weeks? That’s similar to what happened to me when I went through SR in a group. I stayed with it, though, and eventually my sleep improved.

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  7. Wow, thank you for the quick response and that info! I suspected that “cheating” was a main culprit. I have been “cheating” a bit and am not seeing as fast of an improvement as a group of other people that I am doing this with.

    My life has not gotten more stressful, I just think I am not adhering to the rules as strictly as I should. I tend to fall asleep on the couch anywhere from 30mins to almost an hour before my sleep window. Then I will wake and move to the bed. If I don’t go to the bed very tired then it is very difficult to fall asleep so have to find the happy medium there.

    I plan on sticking with it too. Thanks for the encouragement!

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  8. You’re very welcome. I too found myself nodding off before my scheduled bedtime sometimes. To stay awake, I practically had to force-march myself around the house! Playing the piano worked, too.

    Doing something that involves bodily movement might help you stay awake until your scheduled bedtime. (I offer a few suggestions in this blog: https://thesavvyinsomniac.com/pre-sleep-activities-for-the-sleepless.) Hopefully then you’ll crash!

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  9. Hello Lois,

    I recently started sleep restriction therapy about 3 days ago, and I’m not too tired during the day even though I barely slept the last two nights. Is this normal? I set my bed time 3:30am and force myself to get up at 9:30am even if I haven’t slept too well. Should I restrict my time even more if I’m not too tired? Additionally, I find that I become anxious when I am in bed sometimes. Do you think I should get out of bed if I am anxious?

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  10. Hi Chris,

    Sleep restriction therapy can help a lot for people who have insomnia.

    In your case, though, I’m wondering if your sleep problem would be diagnosed as a circadian rhythm disorder instead. Do you normally have trouble falling asleep before 3:30 a.m.?

    If so, your problem might be Delayed Sleep Phase Disorder (DSPD) rather than insomnia. Before going further, let me refer you to a blog I wrote about this problem: https://thesavvyinsomniac.com/q-a-solutions-for-sleepy-night-owls

    I suggest taking a look at that blog before going any further. Also, if you have the opportunity and the inclination, you might try to get a proper diagnosis from a sleep specialist.

    Sleep restriction therapy is good for people who want to consolidate their sleep: get to sleep faster and cut down on nighttime wake-ups. But to benefit from it, you have to begin with a sleep window that equals the average amount of time you sleep each night (as opposed to the time you spend in bed).

    You’ve set a sleep window of 6 hours (3:30-9:30). Is that an arbitrary number, or did you actually keep a sleep diary for a week and find that you’re sleeping an average of 6 hours a night? Before starting to restrict your sleep, you need to gather data on how much you’re actually sleeping to maximize your chances of success with SRT.

    It’s a never a good idea to stay in bed when you’re anxious. You start to associate your bed with anxiety–which really interferes with getting to sleep.

    If after 10 or 15 minutes you find you can’t sleep, go out of your bedroom and do a quiet activity like reading or listening to music. Only go back to bed when you feel yourself getting sleepy again.

    I wouldn’t worry too much about not feeling tired during the day. On that score, if I were you, I’d feel fortunate!

    Best of luck wherever you go from here.

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  11. Hi Lois
    I have found your website and video’s very encouraging.
    I am on my 4th week of sleep restriction and have had lots of ups and downs. My sleep time is 12-6 and I was getting improvement but still having at least 2-3 bad nights/week when I get 3-4 hrs and then I completely crash like last night at 10:30 now I feel very anxious that I have undone all my hard work. I have 2 small children who also often wake during the night that makes this so much harder and I have also just come off remeron this last week too. I can’t help but wonder if it’s all worth it. Interested in your opinion on the length of time this therapy takes to really see consistent results. Thanks

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  12. Hi Keryn,

    Going through sleep restriction while having to care for 2 young children who don’t yet sleep through the night is a real challenge. The aim of sleep restriction is to enable you to consolidate your sleep: fall asleep more quickly and sleep right through the night. Yet you’re in a position where you can’t sleep through the night because you have to tend to the needs of your children. This makes it difficult to discover what your body’s ideal sleep window really is.

    I have a couple thoughts here. I suspect you’re crashing on some nights at 10:30 because you really are short on sleep. I don’t think that going to bed a bit earlier on some nights should be cause for concern in your case.

    Ideally, when undergoing sleep restriction, you set a bedtime and a wake-up time and stick to them. But you aren’t in an ideal situation. So whether or not you’re able to adhere to your chosen bedtime, you should always get up at the same time every morning. (Also, take care to avoid naps.) A fixed wake-up time is really the most important thing. It will enable the build up of sufficient sleep drive to put you to sleep and keep you sleeping the next night.

    As far as how long it will take to see consistent results, I think it’s a very individual thing. I started seeing results by the end of the first week. Others in my group started seeing results by the end of the second and third weeks of treatment. But none of us were contending with small children who were up at night. In your case, the process might well take longer.

    You haven’t said how old your children are. If they’re still babies this suggestion will not apply. If they’re a little older, though, I’d try talking to my pediatrician to see if there were any changes I could make–in the timing of bedtime, or the bedtime routine, for examples–that might keep the kids from waking up so many times at night. This would be a great help to you.

    I really admire your persistence in trying to improve your sleep. I wish you all success.

    Lois

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    1. Thanks for the reply Lois. My kids are 6 and 3 and they probably sleep through the night 3-4/week the nights they do wake they usually complain they have had a scary dream and I stay with them until they are back asleep as I don’t want them coming into our bed. We have tried many things with the kids and they have improved but staying with them for the 5 minutes it usually takes for them to go back to sleep is the easiest for me right now. My insomnia actually started because of my son 1 year ago he saw something on TV that really scared him and we had months of very bad nights we took him to a child psychologist and gradually he improved but this led to me anticipating how many times I would be up at night and how long it would take me to settle him down hence eventually leading to problems with my own sleep which as my sons sleep improved mine got worse. My issue is falling asleep, if I fall asleep easily I seem to have confidence that I have fallen asleep and even if the kids wake don’t have any trouble falling back asleep. But if I take a long time to get to sleep I usually have a bad night. I do get up religiously at 6 it’s pretty easy as my 6 year old is usually up at 6:30 anyway and I work 3 days/week so it means I get to work on time. My biggest issue is sleep anxiety and on the nights when I’m more wound up I have lots of trouble getting to sleep and for me I feel the risk of not sleeping is high as I have kids/work etc to contend with during the day. I’m only 34 years old and I’m trying sleep restriction to attempt to go back to something like the sleep I used to have which even through breastfeeding my 2 children never had any problems with sleep. I am determined to improve the situation so I’m trying to stick this out but if I don’t start seeing more consistent improvement soon I’m not sure how much longer it will last.
      Thanks again for your reply.

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      1. Keryn,i know your post was from a year ago but i found it too close to home! your situation sounds exactly like mine. My 2 year old had MAJOR sleep regression for a few months and while i worked hard with him to get his sleep back on track, my sleep took a huge dive. I can, most times go to sleep ok, but cant sleep through the night. am up for a few hours. I also have sleep anxiety and also did just fine during nursing my son as far as my own sleep. i literally felt like i was reading about myself when i ready your post. did you get any positive relief from sleep restriction? how is your sleeping now? i used to get 9 hours a night up to this whole sleep thin started a few months ago. Am on day 2 of restriction (6 hrs per night) and am feeling the drag 😦

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  13. Hi Keryn,

    I think there’s reason for some optimism here in what you say. First, you mention having slept well before the incident where your 1-year-old saw something scary on TV. If you’ve known good sleep in the past, you’ve got more going for you than someone who’s never been able to sleep well.

    Next, it sounds like your children’s sleep has improved since they’ve gotten older, and that that they’re sleeping through the night 3 or 4 nights a week. So you’ve got more control over the timing of your sleep than you would if they were still infants.

    The pattern you describe–going through a stressful period (with your 1-year-old), sleeping poorly as a result, and then developing anxieties about sleep that perpetuate the sleep problem–is apparently very common. I developed similar anxieties myself. (I’ve written about this in my book and in an article recently published in Psych Central: http://psychcentral.com/lib/putting-the-fear-of-sleeplessness-to-rest/00018758)

    Sleep restriction is part of an approach to treating insomnia called cognitive-behavioral therapy (CBT) for insomnia. It was the most helpful part of CBT for me: not only did sleep restriction help me regularize my sleep, but it also helped me get rid of my anxieties about sleep. As I developed the ability to fall asleep more quickly, I stopped being afraid that I wouldn’t be able to fall asleep.

    To do that, I had to restrict my sleep to a rather narrow window at first–from 12:30 to 5:15 (based on info I’d collected in my sleep diary, showing that on average I was only sleeping then about 4 hours and 45 minutes a night).

    If you want to continue sleep restriction, I’d suggest tightening your sleep window to 5 1/2 hours a night, and maybe even 5 hours, and adhering strictly to your bed and wake times even though you may feel like crashing. I suspect you’ll get quicker results, which in turn would lessen your worries about sleep.

    You might also benefit from a part of CBT called “cognitive restructuring.” It involves working with a therapist who tries to help you cut down on catastrophic thinking about sleep and adopt a more realistic mindset. (You might also be able to go through this process on your own with the right materials. But having an in-person guide would probably be easier.)

    Some people I’ve spoken with have found cognitive restructuring quite helpful–it’s helped to lessen their anxieties about sleep. I’ve written about it in my book and a little bit about it here: https://thesavvyinsomniac.com/laying-fear-of-sleeplessness-to-rest.

    But your comments make me think I should I should write something more about it on my blog. Look for it sometime in the near future!

    Again, Keryn, best of luck.

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    1. Thanks again Lois for the positive encouragement I need lots right now. I think I will purchase your book not sure if I can direct from your website as I’m in Australia (there is very little insomnia books written by Australian authors from my research). The cognitive restructuring sounds like it would help me I will ask my sleep psychologist at the sleep clinic im doing the SRT at, about it and she may be able to help me use it. I look foward to your new posts on this topic.

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  14. Good to hear you’re already working with a sleep psychologist. She could very well be able to coach you on the cognitive restructuring part of CBT. I’m also planning to blog about it in the next week or two.

    Re: my book, The Savvy Insomniac, I’m not currently set up to sell it as an e-book directly from my website, but I intend to make it available soon. Shipping charges to send the print version to Australia are prohibitively expensive (they’re more than twice the value of the book!).

    But The Savvy Insomniac is available in e-book formats from Amazon and other online booksellers–this might be the best way for you to obtain it if you want it right away. Chapter 8 is the chapter dedicated to exploring CBT.

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  15. Hi

    It was great to see your site and gain confidence in sleep restriction. I’m on week 1 of sleep restriction and am struggling. My average sleep was 5.15 hours so I go to sleep at 12.30 in the aim to wake at 5.45. My problem is I feel so tired at 10pm ish and by the time 12.30 comes I’m over tired and it takes me hours to get to sleep. I follow the programme and get up etc and try again so now I’m lucky if I get 4 hours. Also it doesn’t seem to matter what time I go to bed I still wake at 5am so just end up with less. Is this normal?

    Also on nights if I don’t fall asleep until 3am do I still set my alarm to wake at 5.45 as that’s supposed to be my wake up? Because I’ve been letting myself get up later those days otherwise it would only be a few hours sleep. But I have read you have to get up the same time each day so I hope I’m not doing it wrong?
    I hope that makes sense!
    Thank you for your help!

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  16. Hi Gemma,

    The first week of sleep restriction can feel discouraging, and for all the reasons you mention here.

    In response to your question about the wake-up time, it IS important to keep the same wake-up time every day, regardless of when you go to sleep. If you allow yourself to vary the wake-up time, you won’t build up the sleep drive you need to consolidate your sleep or make it consistent and dependable. Your sleep will probably continue as before.

    I used to be a very erratic sleeper, allowing myself to sleep in when I didn’t get to sleep till late at night. Then I went through sleep restriction. Because my sleep was so erratic, there were some nights during the first week when I got 2, maybe 3, hours of sleep. During the day, I felt a crushing fatigue, as though my mind and body were trying to move through mud.

    But I held fast to my wake-up time. And by the end of the first week, I was falling asleep right on cue and for the most part sleeping through the night.

    For me, too, it was a struggle sometimes to keep myself awake until my chosen bedtime. To do this and to avoid getting stressed out about it, I found I had to do activities that involved a bit of movement, like playing the electronic piano or rearranging bookshelves or even just walking around the house. Sitting & reading was too passive. I’d find myself nodding off well before my bedtime. The effort it took to rouse myself, and the anxiety it created, could keep me up for many hours.

    I wouldn’t normally advise changing course right away. If I were you, I’d probably stick with the times I’d chosen for one week, and then re-evaluate after calculating my sleep efficiency. (You’re aiming for an efficiency of at least 85, and better yet 90, percent.)

    That said, one thing the sleep restriction protocol does permit is setting a wake-up time of your choice. Since your body seems to want to wake up at 5 a.m.every day, I’m curious about why you didn’t set your sleep window at 11:45 to 5 rather than 12:30 to 5:45. That might be a better place to start.

    Keep me posted on how it goes.

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  17. Thank you that’s reassuring. I initially wanted to try and wake up later as I was fed up of waking up do early every day and wanted to change my wake up time from 5.15 until later. But now I’m going to accept that as my wake up time for now and concentrate on getting a solid sleep pattern. I’m going to go to bed at 11.45-12 tonight and at least that may help.
    Thank you it helps to know it works because I started to feel like it was making things worse. I’ve always been able to fall asleep instantly and my problem is not staying asleep and waking in the early hours.
    You’re right, I’ve been reading etc and today I’ve bought a zigsaw and may try a few other different things to keep away. I’m dead on my feet at 10pm and by 12 wide awake, I’m hoping my body will reset itself.

    Thanks again for your help I really appreciate you taking the time to reply.

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  18. You’re certainly welcome, Gemma. Stick with this a couple weeks and see if it doesn’t work. Best of luck!

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  19. I am trying to come off sleeping pills which i have been on for 3 months, which only give me 3-5 hours sleep, and on some nights zero. I started the sleep restriction 5 nights ago (1am – 6:45am), 3 nights have been without medication. But i tend to have trouble staying awake until my sleep time and keep falling asleep on the sofa, and then when i get to my bedroom i am wide awake, and can not go to sleep. I think the main reason that i can’t stay awake is that over the past 5 nights, i have had less than 2 hours sleep a night, with the exception of one night where i passed out much earlier in the evening (9:30pm. Should i move my sleep time to a little earlier?

    My sleep issues only started 3 months ago, prior to that i was a reasonable sleeper, but i always went to bed late, which is why i set my sleep time to 1am.

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  20. Hi Beverley,

    One of the biggest challenges of sleep restriction, at least during the first few weeks, is finding ways to keep yourself awake until the bedtime you’ve chosen.

    The fact that you were a reasonable sleeper as recently as 3 months ago bodes well for a return to the kind of sleep you had before. And if you’ve always gone to bed late, it makes sense to set your bedtime at 1 a.m. during sleep restriction. The thing you have to do now is find ways to keep yourself awake until that time.

    This was a big challenge for me, too. I couldn’t do anything too passive–reading or watching TV–because I always found myself nodding off early. Then, when my designated bedtime finally came around, like you I was wide awake again.

    What I realized was that activities involving a bit of movement could keep me up until my designated bedtime. I ended up playing an electronic piano (which I can play without disturbing others at night) and doing light house chores. When I could do nothing else, I simply walked around and around the house.

    I wouldn’t normally choose to do these things in the hour before bedtime. And when my sleep started to feel more solid, I didn’t have to do them anymore. But they worked well in the first few weeks of sleep restriction, when I did feel sleep deprived.

    I’ve written a blog suggesting a few other activities that might be good during sleep restriction in the run-up to bedtime. You might find it helpful, so here it is:
    https://thesavvyinsomniac.com/pre-sleep-activities-for-the-sleepless

    On the issue of sleeping pills, it’s my understanding that to really benefit from sleep restriction and consolidate your sleep, it’s important to forgo the meds.

    Best of luck moving forward!

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  21. Hi

    I wrote a few weeks ago to ask for advice about sleep restriction. Since then I have had some success. I have managed to have a week of successfully sleeping through without waking for 5 hours. However I can’t seem to keep it up. I then have had a week of poor disrupted sleep where the programme doesn’t seem to be working and I’m more tired but then another week of good sleep after! I just start feeling positive and that there’s light at the end of the tunnel and thinking that I can start going to bed a bit earlier before I seem to go back to the beginning. Is this normal? I feel like I’m taking two steps forward and two steps back again etc I am now coming to week 5 of sleep restriction. How long do you think this should take? I can’t see any reason for this other than when I have one bad night I feel disheartened and my anxiety increases because I had been so happy when it was starting to work.
    Many thanks

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  22. Hi Gemma,

    If you’re following the sleep restriction protocol to the letter, then at 5 weeks you should be seeing some progress. On one hand, it’s hopeful that you’ve had SOME good weeks. On the other, that upward progress is getting interrupted, and that is disheartening, I’m sure.

    When I went through SR, I started noticing improvements fairly soon. But my progress was not linear. On some nights I’d fall asleep quickly and sleep right through the night. On other nights, I wouldn’t fall asleep so quickly, or I’d wake up in the middle of the night and have trouble falling back to sleep. This created anxiety about whether the process was really going to work for me. Understandable, since for so many years I’d struggled with insomnia, but it did feel like something of a setback. I stuck closely to the protocol, though, and eventually came to a place where the good nights were way more common than the bad.

    I have a couple thoughts about your situation. I’m wondering first about how, after a week of observing the five-hour time in bed, you’re recalculating your sleep window for the following week. You may feel like letting down your guard and going to bed at the first sign of a yawn. But even when your sleep efficiency is very high during that first week–90 percent or better–the protocol only allows for 15 more minutes in bed the following week. So your time in bed increases very slowly.

    I’m wondering if in your case you’re trying to increase your time in bed too much too fast?

    When you do start increasing your time in bed, you can add the extra 15 minutes at the beginning of the night or at the end of the night. I recall you’ve never had much luck sleeping past 5 a.m. So I presume what you’re doing right now is adding time at the beginning of the night. But once you have a solid week of sleeping 5-hour nights, maybe instead of going to bed 15 minutes earlier in the evening, you should continue going to bed at the same time but try extending your window to 5:15 in the morning for a week and see if under these conditions you have more success.

    The other thing would be to try addressing your anxieties about sleep directly. I’ll get back to you with a few more thoughts about this later today.

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  23. Thank you for your time in replying. I guess thinking about it you’re right. I’ve had more good nights recently and had 6 nights sleep solid for 5 hours so I guess I should think of that positive and hope that maybe it will start to continue for longer periods. I’ve been going from half 12 until half 5. It’s hard when I get a bad night to not panic and then create a downward spiral. I have been strict in my timings and haven’t tried going to bed earlier yet as I haven’t had a full week yet. I was thinking about trying from 12 until 5 instead but I think now I will stick with my current plan of 12.30 until 5.30 and hope it starts being more consistent? The problem is sometimes getting overtired and not being able to sleep until half 1 or 2.
    Thanks again for your advice!!

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  24. Hi Gemma,

    It’s good that you’ve been sticking to the protocol. Choose a sleep window and stick with it for a week, then recalculate, building on what you did the week before.

    It may be that your anxieties about sleep are your biggest problem now. Maybe it’s time to address them directly.

    Here are some blogs I’ve written on anxieties about sleep, fear of sleeplessness, and activities that might take your mind off your anxieties at night. If you haven’t already read them, maybe they will help:

    https://thesavvyinsomniac.com/fear-of-sleeplessness-how-and-why
    https://thesavvyinsomniac.com/laying-fear-of-sleeplessness-to-rest
    https://thesavvyinsomniac.com/managing-anxious-thoughts-at-night
    https://thesavvyinsomniac.com/pre-sleep-activities-for-the-sleepless
    https://thesavvyinsomniac.com/ease-insomnia-by-changing-negative-thoughts

    Keep me posted on how this goes for you.

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  25. Thank you for the articles I will have a read through. I agree maybe that’s part of my problem. I have had a look back through my sleep logs and realised that the reason I’ve had problems at the moment is all in falling asleep. I always used to fall asleep in five minutes and then have problems staying asleep. Now I’ve started sleep restriction I haven’t been waking up in the night which is good but I’ve been getting ‘overtired’ and by the time bedtime comes I’ve gone past my sleepy stage and it takes me an hour or longer to fall asleep which never used to be a problem. Did you have this problem? I’ve read your suggestions about keeping awake through sleepiness which were helpful. I don’t know how to stop going past the tired stage and ending up feeling wide awake at bed time?

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  26. Hi Gemma,

    When I went through sleep restriction, sometimes I had a problem staying awake until the bedtime I’d chosen. The effort it took to stay awake was arousing. When my bedtime finally came, I wasn’t very sleepy.

    But I stuck to the protocol. And bit by bit, as my sleep efficiency improved and I was able to add more time in bed, the whole sleep scheduling thing got easier.

    After a couple of months (and by that time my sleep was pretty solid), I realized that looking at the clock at the approach of bedtime was arousing. It was making me anxious, which in turn made it harder to fall asleep. So at some point I decided in the evening to turn the clocks to the wall.

    At night, though, I didn’t go to bed at the first sign of a yawn. That had tripped me up before. Instead, I continued reading until I felt really, really sleepy. Then I went to bed.

    But I set my alarm for the same time in the morning. Of all things, I knew my wake-up time really needed to stay firm.

    This is pretty much how I manage now.

    If you could find something enjoyable to do in the run-up to bedtime (even if mentally and physically you’re not at your best), you might feel less anxious about your sleep. That could only help.

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  27. Dear Lois

    I’m on day 3 of sleep restriction and feeling pretty desperate. Usually I go to bed at 10 to try and get enough sleep before alarm clock goes off at 6.30. I have difficulty getting to sleep and wake repeatedly. I struggle to get back to sleep and then wake too early.
    I decided to try SR and set 12.30 as bedtime .
    First night I couldn’t get to sleep for ages. Then woke at 2.30, 4.20 and 5.30. Only dozed lightly from 4.30 to 6.30 when I got up. Second night, I went to bed at 12.30. Fell asleep more quickly but again woke at 2.45,4.30 and 5.30. Last night I went to bed at 1, to try and sleep in a bit later. Woke at 2.30 and 5.30.
    So having about 4 hours of broken sleep and cannot get past 5.30. Feeling very sleep deprived and down. Have tried every other insomnia treatment and had hoped this would work but so far its just making things worse. My husband sleeps 8 hours straight and this makes it all worse somehow.
    Any advice gratefully received
    Jane

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  28. Hello Jane,

    I’m sorry to hear about your sleep problem, but glad you’re looking out for ways to manage your sleep.

    Your experience with sleep restriction–sleep getting worse in the first week–is common, I’m told. It happened this way for me, too. The first 3 nights of SRT I hardly slept at all. This felt like such a drag! Yet the upside was that my sleep drive increased quickly. On night 4 I fell asleep at the bedtime I’d chosen & slept through the night. That was the beginning of my better sleep. Progress wasn’t linear, but over time I made substantial gains.

    You mention waking up quite a few times at night, and you seem to know the exact times when you woke up. I wonder if after you go to bed you’re looking at the clock? When you’re doing SRT (and in general) it’s a good idea to avoid looking at the clock once you’re in bed. Clock watching can make you anxious, which of course makes it harder to sleep.

    I find this to be true myself. So my rule is now to turn my clocks to the wall in the evening. You can’t really do that while you’re doing SRT. You have to observe a firm bedtime, and you can’t do that without a clock. But you CAN avoid looking at the clock after going to bed.

    Some people don’t start seeing sounder, more regular sleep until a few weeks into SRT. So I’d encourage you to stick with the program a little longer. Because you’re sleeping so poorly now, you may find that you start making gains fairly soon.

    Good luck!
    Lois

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  29. thank you so much for your reply. It really helps knowing someone out there understands!
    Had a much better night last night. Couldn’t stay up past 11 but fell asleep quickly when went to bed at 11.15. I did wake in early hours but didn’t look at clock or go to bathroom and did fall asleep again quickly. then woke again when it was starting to get light. Did check clock hoping I’d made it through. It was 4.15. The elation of having done 5 hours made it hard to get back to sleep. I lay quietly for 20 minutes. The advice is to get up if you can’t sleep after 20 minutes but I knew that that would be the start of my day if I did. So I read and managed to drift off again tip 6.15. So 7 hours with only a 30 minute interval. Much much better. But what is your advice for those 4/5 am awakenings, which are earlier than before your prescribed wake up time but late enough that it is starting to get light and you have some hours sleep under your belt? I am so grateful for your advice and replies.
    thank you
    Jane

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  30. Hi Jane,

    I’m glad you slept better last night. It does feel so good to get a decent night’s sleep!

    But my advice, going forward, would be to observe the prescribed bed and wake times very strictly while you’re going through SRT. In the hour or two before bedtime, do something that’s quiet but also involves a little bit of movement. That way you’ll keep yourself from drifting off to sleep too early.

    About the early morning awakenings: if it were me, and if I felt reasonably alert and aroused, I’d just get up and start my day, and assume I’d sleep more soundly and longer the next night. If you do choose to stay in bed, again I’d suggest not looking at the clock.

    I hope your sleep keeps improving, and I think there’s a good chance it will if you stick very close to SRT guidelines.

    All best,
    Lois

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  31. Hi Lois
    Thanks for your advice. Just had the worst night. Bed at 11.45. Asleep within 5 minutes. Awake at 2.15 for 45 minutes. Then awake again at 4.15 and couldn’t get back to sleep. I have 4 children and I work so just cannot function on 3 and a half hours sleep. I lay in bed til 5.30 and then resorted to half a sleeping pill which bought me another hour. I’ve hidden the clock but when I wake I go to the bathroom and end up checking clock in there. I know I don’t really need to go but worry that won’t be able to
    Go back to sleep if I don’t. Totally desperate.
    Jane.

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  32. Hi Jane,

    I hear the desperation you’re feeling now. I too have despaired at not being able to sleep even when I felt like I needed sleep the most. It is really, really hard when your body is being uncooperative.

    That said, one thing to keep in mind about SRT is that it’s a treatment that doesn’t generally work quickly. The other thing to keep in mind is that you’re much more likely to benefit from it if you stick very closely to the guidelines. The guidelines are strict: establish your sleep window, and stay out of bed except during that time. Avoid looking at clocks after you go to bed.

    I was glad you reported feeling good about your sleep the night before, but I also noticed that you’d gone to sleep early. My first thought was that you might have trouble sleeping the following night–and that is what happened.

    By the way, I should mention here that many people with insomnia have erratic sleep patterns. We sleep well one night, but that night is followed by one or more bad nights before we have another good night. Here is the URL of the blog I wrote about that: https://thesavvyinsomniac.com/good-nights-bad-nights/

    Back to SRT: it’s my own speculation that when people with insomnia are trying to achieve a more stable sleep pattern–and to figure out when and for how long we should be sleeping–a really long night’s sleep is probably going to interrupt that process. Why? Research suggests people with insomnia may need a larger-than-normal sleep drive to ensure consistently sound sleep.

    Sleeping for 7 or 8 hours may make you feel good the following morning. But it’s going to limit your build-up of sleep drive that day. The result will likely be trouble falling asleep or staying asleep that night.

    If you decide to stick with SRT, I suggest following the protocol to the letter. Only then will you have a decent chance of success.

    If, on the other hand, you find the protocol too exacting given all the other demands on your time–work, the 4 children, and so forth–then maybe it’s time to discuss other options with a sleep specialist.

    Good luck whichever way you go.
    Lois

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  33. Hello Lois,

    (I’m french,sorry in advance for my faults).
    I’m on my first week of sleep restriction and it’s really difficult.
    2 years ago, i tried sleep restriction and it was a success,i was so happy to overcome insomnia.

    For one month now, my sleep is really bad…so i decide to begin a new sleep restriction. My window is 2h-8h (it was the window i use the first time),so 6 hours, but now i only sleep around 3 hours. I don’t understand what happens and why i feel so anxious.This night was awful,i slept at 2h45 and wake up at 5h30…with stress.
    Because of my bad sleep, i take antidepressor (mirtazapine) to help me to calm down my stress and help me to have some rest. I know this is not a solution.With my first SR, i could decrease the dose a lot.

    I don’t want to worry my family but with this bad sleep, i’m not myself,i feel i can cry.I don’t know why my sleep restriction,after 4 nights now, doesn’t seem to work…i know this is the beginning,and my body needs a routine and it can take 2 weeks or more but i feel miserable.
    I don’t know if i have to change my window because at 01:00 i feel sleepy and not at 2:00…it’s like i never experiment sleep restriction and start all over again. Perhaps my window (6 hours) is too long for the moment…I feel anxious when i lay down in my bed.
    Could you give me some advices? and encouragements.
    I bought your book with amazon and i will read it asap.
    Thank u very much

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  34. Hello Niko,

    I’m sorry to hear you’re having a hard time with your sleep. It’s demoralizing when, after going through Sleep Restriction and improving your sleep, something happens to knock your sleep off course. It feels like you’re back where you started, with insomnia that’s never going to end.

    This experience is fairly common, I’m told, especially in people who are sensitive to stress. Some difficulty or problem crops up in your life, you start feeling really anxious about it, and that anxiety makes it harder to sleep. Then you start feeling anxious about your sleep, and suddenly you’re back in the insomnia groove all over again.

    You’re doing exactly the right thing in moving to restrict your sleep again. (In the past several years I’ve had to put myself through a couple “refresher” courses of Sleep Restriction myself.) Hold fast to all the guidelines concerning bed and wake times, resist the urge to nap, leave the bedroom if after about 15 or 20 minutes you can’t sleep, and avoid looking at the clock during the sleep window you set.

    Sleep Restriction worked for you before, so I feel very confident that it will work for you again. In your case, though, you might want to set your sleep window for 5 1/2 hours rather than 6 hours. If going to bed at 1 rather than 2 seems more reasonable, then set your sleep window from 1 to 6:30.

    But whatever the timing of your sleep window, stick with it for a week and see what happens. Recalculate at the end of the week to see whether you can enlarge the window or stick with the same window for another week.

    Sleep restriction may not work as quickly as you’d like it to work. But especially since you’ve had success with it before, I’m certain it’ll work for you again.

    Good luck with it, and feel free to write again.

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  35. Hello Lois,

    Thank you very much for your email, it’s very kind.
    This night, my sleep was really really better.Because of my very poor last nights, i decided to go to bed a little earlier..i put my head on the pillow, i just read some texts on my iphone…and tada, i wake up at 7.00 i think i sleep around 6 hours. I know that i didn’t respect my “sleep window” (2:00 -8h00) but yesterday i was so exhausted, so bad.
    I spoke with my brother about the sleep restriction,he’s a good sleeper and he said “i think it’s a very good method, your sleep needs rules so respect them, don’t think to much,respect them even if it’s hard”. He understands the procedure (he’s a scientist).
    Because of this good night, i’m really motivated now. If sleep restriction is really hard the first weeks, i know that it REALLY works.I “just” have to control my stress, my anxiety…and like you said in another post,people are not equal in front of sleep deprivation.If i need to cry because of it, ok, cry,this is not a shame, it won’t kill myself.
    I will tell you about the next episodes.perhaps i will modify my sleep window (5 1/2 hours), i just have to experiment my sleep during few days. I’m reading your book right now, it’s in english but i understand, it will improve my motivation in sleep restriction…and my english too ! thank you

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  36. Hi Niko,

    You’re certainly welcome for the comments I sent.

    I’m glad to hear you had a better night. Things look so much less daunting when you’re feeling well rested, don’t they?

    A word of caution: try to stick as close to your sleep window as you possibly can. Oversleeping may feel good temporarily, but often it makes it harder to sleep the next night. That’s something you want to take care to avoid.

    I see nothing wrong with crying when you feel like crying. It relieves tension, so why not?

    I hope you find that The Savvy Insomniac is a useful book. Especially since you’re reading in a foreign language, though, you may want to skip around a bit rather than reading it from cover to cover.

    Cognitive-bahavioral therapy is treated in detail in chapter 8. (SRT is of course a part of CBT, and maybe, for many of us, the most valuable part.) But chapters 6 & 7 explore systems in the body that enable SRT & CBT to work. All this information was helpful as I was undergoing therapy myself.

    Keep me posted on how you fare. And good luck!

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  37. Thanks for your site. i am trying this but have a real glitch. I am perfectly capable, when stressed, of staying up all night and this can go on for 3 nights.

    When I am sitting around waiting, exhaustedly, for my 2 am bedtime i am consumed with how little time I have left until the 7 a.m. wake up time. I calculate and say to myself, if I get to sleep now (or 3 or 4) I will only have 4 or 3 or 2 hours sleep. This, then becomes my fixation.

    After a couple of exhausted days and nights i couldn’t go under at 2 or 3 am. I was just so tired that I was nodding off on the couch, but hit the bed and I woke up. So then the calculations started.

    So last night at 3 I turned off the alarm clock and took a half dose of a medication I only take a few times a year. Great i slept till 9:30. So I have blown this day.

    Does this happen to everyone, exhuastion but fear and calculation of hours. I am sooooooo tired and very fearful.

    A large part of me just wants to accept that I am a night owl with insomnia from time to time.

    Any thoughts? Thanks

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  38. Hi Deb,

    Your experience sounds a lot like mine! Many years ago I developed a fear of sleeplessness, which, like my insomnia, seemed to come and go. The hardest part about sleep restriction for me was having to confront that fear face to face. Staying on track with sleep restriction despite my fears and despite my very short nights’ sleep–and consequent exhaustion–was a huge challenge.

    Unfortunately, sleep restriction therapy involves looking at the clock to know when it’s time to go to bed. But, looking at the clock provokes anxiety in people like us! Which is exactly what we DON’T need. It can only make falling asleep more difficult.

    But I was able to stick with the program and I’m glad I did. It has made my sleep more regular and more dependable.

    I tell the story of that experience in chapter 8 of my book, along with the stories of other insomnia sufferers in the group I went through therapy with.

    Not every insomnia sufferer develops anxieties about sleep–but many do. For us, sleep restriction is more of a challenge, I think. You might be interested in taking a look at an article I wrote about it for Psych Central:

    http://psychcentral.com/lib/putting-the-fear-of-sleeplessness-to-rest/00018758

    If you haven’t already taken a look at these 2 blogs, you might also find them helpful:

    https://thesavvyinsomniac.com/fear-of-sleeplessness-how-and-why/
    https://thesavvyinsomniac.com/laying-fear-of-sleeplessness-to-rest

    Anyway, I’d like to encourage you to keep looking at sleep restriction–and cognitive behavioral therapy for insomnia–as something that could very likely help.

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  39. Hi lois,
    I’ve changed my sleep window,it’s now 2/7:30.I think it will be more efficient.

    I’m frustrated because the program (sleep restriction) relatively works some nights but does not work other nights. It’s like a lottery and it’s very frustating. i’m anxious because of it. It’s like my sleep is out of hand. My doctor has given to me a 15 days sick leave because it is really hard to work and prescribe medication :zopiclone (lunesta in US i think).I don’t want to use it every night because i think sleep restriction is a better therapy.But sometimes,when i’m very exhausted and stressed i prefer use one lunesta (even if it’s rare)

    This night was very difficult for me : i was very sleepy at 1:45, i went to bed, i fall asleep but with stress and i woke up at 3:30.and all the night was wake up /go to bed/wake up/go to bed….you know that. So today,i’m a little depressed because i work hard to beat my insomnia with sleep restriction and the results,for the moment, are not really good.

    Do you some advices to help me a little bit? thank you very much lois.

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    1. Hello again, Niko,

      One more thought I had about your situation. It isn’t a good idea to go through sleep restriction when you’re really busy with or stressed out about work. Neither is it a good idea to take time off work or stop your normal activities.

      The strength of you sleep drive depends mostly on how long you’ve been awake, and how long you slept the night before. It depends to a smaller extent on what and how much you do during the day. So during SR it’s best to continue with your normal work routine if you can.

      Personally, I find that late afternoon or early evening exercise really improves my sleep. Especially if I’m feeling stressed out about work or something else, an early evening workout calms me down helps me fall asleep more quickly.

      You may already be getting regular exercise. If not, doing some sort of regular exercise would be helpful–even though it’s hard to muster up the energy to do it when you’re feeling short on sleep.

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  40. i’m reading the chapter 8 of your book and you exactly describe what i feel these days (“my stomach clenches up””here we go again””warm”…) it’s just the same thing!
    I think lunesta is not a good idea, my doctor doesn’t know about sleep restriction…when i explained to him he just said to me that “it’s funny,but you can’t control your sleep”….funny?god. i know i can’t sleep when i want but sleep restriction can be so helpful (i tried it two years ago with success…here we go again,i have to go through these bad times.But the first time,it was easier).
    I didn’t take lunesta the last two days and i think it’s the best choice. The sleeping pills can “help” but i won’t beat my chonic insomnia with it….i have to be patient with the sleep restriction. But when i wake up at 3:30 in the morning this night with stress,it was like a nightmare!

    In france, we haven’t got “therapy group”…so your book and your blog is helpfull,i’m not alone with this problem,with this “elephant in my bedroom”.

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    1. Hi Niko,

      I’m really sorry you’re having such uneven nights. It must feel disappointing, especially since you had faster success with sleep restriction before.

      I suspect what you describe is a fairly common experience, though. You’re going through sleep restriction and feeling anxious about your sleep. That’s bound to make your sleep erratic.

      Since you’re reading my book, you know that anxiety about sleep was something I struggled with, and that made SR especially hard. But–and this is ironic–the anxiety may actually have made SR work more quickly for me than it would have otherwise. It kept me awake until very late. I got so little sleep in the first few days. I was so sleep deprived that there was nothing I could do BUT sleep.

      Still, for me, the improvement I got was not steady. One night I’d sleep the whole night through, and the next night I’d wake up very early. The next night I’d sleep OK, and the following night I wouldn’t get to sleep until very late at night. It was touch and go for a while.

      But overall, by the end of the second week of SR, I was noticing that my sleep had improved. I’d like to encourage you to continue with the process. Eventually your sleep drive will build high enough that you WILL experience more regular sleep. That’s the way sleep deprivation works: your body’s demand for sleep gets so high that there is nothing you can do but sleep.

      All best in your efforts to continue the process,
      Lois

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  41. Thank you so much for your time and energy to support people suffering from insomnia like myself. I am still planning to buy your book as I reside in Africa but could you help meanwhile…

    I am on the third week of sleep destriction and already getting some benefits like falling sooner when I go to bed. However I have serious difficulty to keep my wake up time. In the first week my bed time window wa 12 to 5 in the morning. The first few days I was sleeping for 2 to 3 consolidated hours and by the end of the week I was sleepingfor 4 to 4 40. I will wake up at 5 but will have again a huge urge to sleep after 30 minutes to 1 hour.

    In the second week, giving that I was feeling relatively energised, I added 15 minutes therefore putting bed time from 11 45 to 5, still some days I will wake up at 5 other days I will feel extremelly sleepy after 5. Now in the third week, I was thinking of putting my wake up time at 6, bed time window from 11.45 to 6. What do you think? please I need your help

    Beatrice

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  42. Hi Beatrice,

    It sounds like you’ve already experienced some gains with sleep restriction, and I’m really glad to hear that. Given the gains you’ve made, I think you’ll really benefit from sticking with the program.

    The best way to do that is to follow the guidelines to the letter. If in a given week you find you’re sleeping at least 85% (and better yet 90%) of the time you’re in bed, you’re allowed to extend your sleep window by 15 minutes the following week.

    In your case, you’re sleeping well with a window of 11:45 to 5:00. Now would be the time to increase your window by 15 minutes. Since wake-up time is the big challenge for you, set your sleep window in Week 3 to this: 11:45 to 5:15. If after the 3rd week you still find you’re sleeping most of the time during that window, in Week 4, set your window from 11:45 to 5:30. And so forth, until you find what seems to be the ideal sleep window for you.

    Make sure, though, that you’re always sleeping at least 85% of the time you are in bed. If your sleep efficiency is between 80 to 84%, stay the course for another week. If your sleep efficiency drops below 80%, subtract 15 minutes from your sleep window and continue with that.

    The problem with your setting a sleep window now from 11:45 to 6 is that you’re liable to find this results in trouble falling asleep and broken sleep again. Allowing too much time in bed too quickly will decrease your chance of success.

    In order to get sleep restriction to work as it should, you have to add time in bed in increments of 15 minutes a week. This may sound miserly, but sticking closely to the sleep restriction protocol is the best hope you have of really improving your sleep.

    Here are a few suggestions that may boost your energy and alertness in the morning. Immediately on waking up, expose yourself to plenty of bright light (sunlight is ideal). Movement helps too, so if you can fit it in, an early morning walk may help.

    Also, although too much caffeine in the afternoon and evening can make it hard to fall asleep, caffeine early in the morning is helpful if you’re having trouble waking up. In fact some sleep therapists actually recommend using caffeine in the morning for their patients going through sleep restriction.

    (By the way, this week I’m going to see if I can make my book available to people in more countries at a lower price. Overseas shipping costs are exorbitant when you’re sending things from the US. But there may be possibilities I’m unaware of. Which country in Africa are you from?)

    All best in staying the course with sleep restriction!

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  43. Hi Lois,

    I have seen a sleep specialist a couple of times about the quality of my sleep. I was sent off for a sleep study which to my surprise came back with around 80% efficiency.
    I was dumbfounded. I thought that they must have my results mixed up with someone else’s. I remember waking up several times throughout the night and being utterly exhausted the next day.

    Anyhow, she recommended sleep restriction which I have been doing for 5 nights now. I’ve also been wearing a fitbit to bed to track my sleeping habits. I am going to bed at 9pm which is my usual time and waking up at 4am. Things just seem to be getting worse each night. My fitbit tells me I am getting around 4-5 hours of sleep a night,waking up around 10-15 times per night And taking 15 minutes to fall asleep. I’m absolutely exhausted. Do you think I should continue or have any tips for me? ( I’ve also just come off sleeping pills)

    Any advice you can give me would be much appreciated.

    Thanks in advance.

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  44. Hi Rachel,

    I’m sorry you’re having such trouble with your sleep. Waking up in the morning feeling unrefreshed is a real drag. I’m glad, though, that you’re working with a sleep specialist. While some general practitioners are well informed about insomnia, you’re really better off seeing a specialist.

    I do have a few comments about your situation. First, if you have insomnia, a sleep study may not give you a full picture of what’s going on with your sleep. The study only assesses your sleep on a single night. In people with insomnia, sleep quality, efficiency and length tends to vary quite a lot from night to night. On the night you went in for your study, your sleep efficiency might have been fairly high–80 percent. It might not be that high on many or even most other nights.

    (The Fitbit and most other commercially sold personal monitoring devices are not very good at assessing sleep in people with insomnia, either, by the way.)

    Eighty percent sleep efficiency is not bad, but it’s not real good, either. Ideally you’d want it to be 85 or, better yet, 90 percent. So it’s likely that sleep restriction could help.

    Before you start restricting your sleep, though, you need to keep a sleep diary for a week or 2 to find out the average amount of time you’re sleeping at night. If what the Fitbit says is accurate (and we can’t be sure it is), you’re getting only 4 to 5 hours’ sleep a night. So you’d begin your sleep restriction program by restricting your sleep to 5 hours a night.

    The sleep window you’ve set for yourself is 7 hours. Because this is considerably longer than you’re actually sleeping, it isn’t very likely that you’ll improve your sleep efficiency if you continue on this program. You’ll keep having lots of wake-ups at night.

    If in fact you’re really sleeping only 5 hours a night, that’s where you need to start your sleep restriction. Stay on a 5-hour schedule for a week, and recalculate your efficiency at the end of the week. If it goes up, give yourself 15 more minutes in bed the next week. And so forth, increasing your time in bed by 15 minutes a week.

    The point of sleep restriction is to consolidate your sleep, and by following the rules, it’s more likely your sleep will become more solid. Eventually you’ll find your ideal sleep time. When you do, stick with it.

    Hope this helps!

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  45. Dear Lois,

    First of all, thank you for this site, for the book and for your thoughtful comments on insomnia. This is the most informative resource I found.

    I have been having problems sleeping for more than 10 years. My usual pattern is that I fall asleep fairly easily but wake up at 3-3:30am and cannot sleep anymore. I often feel foggy during the day. I have asthma, so at first I thought it was a problem with breathing. But it is managed now, so I don’t think it is that. I went for a sleep study at a hospital, but since there one needs to be on his back (and I cannot sleep on my back), I felt like I did not sleep at all. The hospital claimed that I did sleep for 30 min and that this period was sufficient to assess my sleep. They did not find any problems with my sleep, but I still have my doubts that 30 min was enough for an estimate. I used to have 2 glasses of wine with dinner, so I excluded that. Stress at work? Yes, but I think it is manageable.

    Anyway, now I am on week 3 of SRT. I definitely feel that overall my sleep is better (I have just added 15 min for the first time to my 6 hours, so not sure if I have enough data to definitively say). I do feel much more tired during the day and often struggle to stay awake, but from everything that I read about SRT, it is to be expected. I also use the Jawbone bracelet to track my sleep. Interestingly, even though before starting SRT I felt like many nights I would spend part of the night not sleeping, the app that comes with the bracelet only showed “light sleep” (as opposed to “deep sleep”). I noticed though that even when it shows a large percentage of “light sleep” I feel fairly tired during the day. Maybe light sleep (as defined by Jawbone) is not restorative enough?

    Anyway, I am fully committed to try the SRT to the bitter end, so will report on my progress.

    Your comments did give me a lot of hope and helped me deal with being sleepy during the day. Thank you!

    Benny

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  46. Hi Benny,

    You’re welcome for the website & the book, and I appreciate the compliments! My struggle with insomnia started early on, so I’ve really felt a need to learn as much about it as I could, in hopes of improving my own sleep and sharing what I know with others in similar situations.

    It’s great that you’re persevering with sleep restriction. The first couple weeks are no picnic. But hopefully you’ll begin to note some sustained improvement fairly soon.

    I’m not surprised at your disappointment with the sleep study. Sleep studies as they’re conducted today are not very helpful to people with insomnia. My strong suspicion is that in your case they were looking to see if you had sleep apnea. Evidently they ruled that possibility out, which is good. At the same time, they did not (and could not, looking at only 30 minutes of your sleep) shed any light on the nature & severity of your problem with insomnia. I can’t count the numbers of people who have told me stories similar to yours.

    During the lighter stages of sleep, people often feel like they’re awake. This is especially true for people with insomnia. There may be some low-level information processing occurring even as the rest of the brain is asleep.

    Deep sleep is indeed more restorative, and the main goal of sleep restriction is to consolidate and deepen sleep. My expectation would be that the process you’re going through now will eventually lead to more restful nights.

    Keep us posted on your progress, and thanks again for your appreciative comments!

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  47. Dear Lois,

    I have found this site very helpful as I have been dealing with severe insomnia that came on rather suddenly. I am starting sleep restriction therapy and having a difficult time.

    My sleep in the past few weeks has been extremely low – in many cases less than 2 hours. I feel very tired physically, but with high anxiety levels about sleeping that awaken me as soon as I hit the pillow.

    My sleep therapist had me start with a 5-hour window and with strict instructions to get up if I didn’t fall asleep within 20 minutes or so. It’s this getting up part I find difficult, not the part about sticking to a clear bedtime and wake time. I feel “pressured” to fall asleep quickly, and after a few times of getting up and then back to bed, up and then back to bed, I get so discouraged I want to just stay in bed, sleep or no sleep. What are your thoughts?

    Marie

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  48. Hi Marie,

    I’m sorry to hear you’re having a tough time with insomnia, but I think it’s great that you’ve taken the bull by the horns and are seeing a sleep therapist about it. I’ll guess that better times are ahead.

    You’re right, sleep restriction therapy involves a strict protocol. I felt the same way you do about the 20-minute rule: I hated it! While my time in bed was being restricted, the last thing I felt like doing was hauling myself out of bed just because I wasn’t sleeping. (Although being in bed while not sleeping is no picnic either.)

    At that point I wasn’t sure behavioral therapy was going to work for me, but I wanted to give it every possible chance TO work. So I followed the protocol to the letter, including getting out of bed when I wasn’t sleeping. (I document that experience in chapter 8 of my book.)

    The upshot was that during the first 3 days of SRT I didn’t get much sleep at all. But with such a big sleep debt, my sleep improved quite rapidly after that. As long as I observed my go-to-bed and get up times, I slept quite soundly during my allotted sleep time and no longer had to get in and out of bed several times before falling asleep.

    The 20-minute rule is a drag. But if you can force yourself to observe it, you’re better off. The aim of the rule is to help you break the association between being in bed and not sleeping, and replace it with the idea that when you’re in bed, you are going to sleep. Learned associations like this one are hard to unlearn, but you stand to gain a lot if you succeed.

    That said, though, the most important thing while you’re going through this process is to strictly observe your sleep window. Simply doing this will eventually lead to sounder sleep and much less trouble with insomnia.

    Good luck & feel free to write back!

    Lois

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  49. Hello Lois,

    I came across your website from a search on sleep restriction and was impressed by your approach to the topic of insomnia. Thank you for taking the time to share the latest research and your own experience.
    I’ve been suffering from insomnia since using a CPAP machine 4 years ago, waking up frequently in the night and failing to achieve the deep core sleep, most of the week. This comes and goes, however, but lately it’s been 6 weeks of struggle. I never suffered from insomnia previous to using a CPAP machine, but I believe the intrusive nature of CPAP has caused a continued state of hyperarousal affecting my quality of sleep.
    I’m also the one that has tried everything, so I’ve committed to try sleep restriction. It’s a challenge to find my sleep window, because I don’t have problems falling asleep but staying asleep. However I know achieving 3-4 hours of deep sleep makes a significant difference, so I’ve carved my time to 5 hours a night (1:15 to 6:15am). I’m currently on my 2nd day of my 5-hour sleep window.
    It’s brutal as everyone has mentioned, but I hope this will work to consolidate my sleep. This is definitely not for the faint at heart, takes discipline and perseverance. My sleep doctor recommended CBT-I and I knew about this approach as a psychologist. Thank you for your encouragement and reading my post.

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  50. Hello Brad,

    I can well imagine that using a CPAP machine feels intrusive. But it seems to be the best treatment for sleep apnea that exists today. I understand, though, that researchers are developing others.

    Quite a few people with sleep apnea also suffer insomnia. The CPAP enables better breathing, which at least in theory should cut down on your nighttime awakenings. But there are many other things that can disrupt sleep and cause insomnia. CBT-I may be able to help.

    You’re right, the process does take a lot of discipline at first. Sticking with a 5-hour sleep window when you feel exhausted at the end of the day is rough. Yet doing that you’ll sooner or later consolidate your sleep. And consolidated sleep tends to be deeper and more restorative than sleep interrupted by frequent wake-ups.

    Best of luck with this protocol. If you’re actually working with a sleep doctor, there’s every reason to think you’re going to benefit–and maybe sooner than you think.

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