Sleep restriction for insomnia may be easier to comply with if insomniacs are allowed a brief afternoon napLesley Gale was a light sleeper who began to have insomnia about 8 years ago. She consulted doctors and tried the remedies they proposed, but nothing seemed to work. Investigating on her own, she came upon a treatment called sleep restriction therapy, or SRT.

“I had heard of SRT before,” Gale wrote in an e-mail, “having seen a couple of documentaries on TV about it, and then did further reading on the Internet. But for years I dismissed it instantly as being absolutely impossible for me, as I’m sure a lot of other people initially react.

“‘I need my 8 hours,’ I thought. I couldn’t possibly stay awake until the early hours of the morning—I’m a confirmed morning lark, not a night owl.” Having to stay up late was not the only problem Gale foresaw. Napping, too, was off limits during SRT, and for years, this was a deal breaker. “I can’t live without naps,” she said.

SRT and Naps

SRT, a behavioral treatment for insomnia, involves restricting time in bed for a while and then slowly adding time back in as sleep improves. Restricting time in bed is helpful because it enables a robust build-up of sleep drive during the day. The greater your sleep drive at bedtime, the more readily you’ll fall asleep and the more likely you are to sleep through the night. Anything that interferes with the build-up of sleep drive will retard your progress. So napping is generally discouraged.

But napping has never been strictly prohibited. In the first weeks of SRT, insomniacs tend to experience mild sleep deprivation, which can sometimes result in overwhelming sleepiness during the day. Sleepiness is dangerous if you’re driving a car or operating machinery. People are advised to avoid such dangers by taking a nap, but to keep the nap short. “No more than 30 minutes,” is the advice my sleep therapist gave me.

A New Perspective on Napping

Then a few months ago, I read about a study being conducted by Nicole Lovato, a postdoctoral research associate at Flinders University. The purpose of Lovato’s study is to find out if adding a 20-minute afternoon nap before 5 p.m. to the SRT protocol will not only keep from undermining the treatment but will actually increase its success.

“Even though we know this treatment [SRT] works very well,” Lovato said, quoted in Medical Express, “a lot of patients feel so sleepy that they find it difficult to adhere to their new bedtime, which is often much later than the time they normally go to bed. . . . We’re hoping that daytime napping will make it easier for patients to adhere to their bedtime and get through the day when they’re undertaking sleep restriction therapy.”

Unlike long naps, short naps are unlikely to interfere with the sleep restriction process. When you first fall asleep, you’re in the lighter stages of sleep, and hovering in the lighter stages will not diminish sleep drive. During long naps, on the other hand, you’re likely to descend into deep sleep. Deep sleep is the stuff that reverses sleep drive, and that is what you want to avoid.

A Testimonial

I wanted to have the results of Lovato’s study in hand before blogging about it. But I mentioned the study in the comment section of another blog, and Lesley Gale, whose desperation to find a solution to her insomnia had prompted her to start SRT despite her reservations, saw the comment and responded this way:

“I’m only 2 weeks into SRT, and I was so excited when I read . . . about naps maybe being OK with SRT,” Gale wrote. “Not being able to have naps has really put me off trying SRT before. But a ‘micro nap’ has worked wonders for me twice this week. About 10 minutes each time, I felt invigorated afterwards, and it didn’t affect my nighttime sleep at all.

“I can’t express what a massive relief it has been! Will keep this new favourite tool only for when I’m feeling really, really sleepy during the daytime. Just having that possibility in the back of my mind has made me feel so much more relaxed about making it through till bedtime.”

The Results Aren’t In Yet, but . . .

Reading Gale’s story has prompted me to go ahead and write about adding brief naps to SRT. People are sometimes desperate for ways to manage their insomnia, and if being allowed a 10- or 20-minute power nap in the afternoon before 5 p.m. might make SRT more palatable and easier to comply with, surely the benefits of mentioning it will outweigh the harm. If you try it out, though, make sure to set an alarm clock to keep your nap short and sweet.

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.

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