A few weeks ago I got an email from Julie, who’d written to me about her insomnia before. Here’s how she began:
“I am happy to share with you, 5 months later, that I am sleeping peacefully and soundly! It didn’t happen overnight, but my improvement did happen because of the sleep restriction you recommended!”
This woman is persistent, I thought, and read on. I discovered that, while Julie’s first attempts at this insomnia treatment were strikeouts, rather than give up, she found ways to modify the sleep restriction protocol so it eventually worked.
“I can now say that I’ve gone over a full month without any bad sleep,” she wrote, “and I’m now sleeping 7 plus hours a night!”
I decided to interview Julie, and here are excerpts from the conversation:
Your insomnia started several months ago. What threw your sleep off track?
A health scare, which later turned out to be a false alarm. I didn’t sleep a wink that night, worrying about all the possibilities. . . . All it took [was] 4 bad nights to send me into the chronic insomnia pattern I experienced for the next 5 months: a few good nights followed by sleepless nights—up and down the roller-coaster.
You decided to try Sleep Restriction Therapy (SRT) for insomnia. What led to that decision?
I’d had an insomnia problem 14 years earlier that lasted for 2 years. It was caused by a bladder problem after the birth of my last baby. . . . I tried SRT but was unsuccessful with it because I needed to cure the bladder problem first.
I never expected to sleep poorly again after what I went through and solved 14 years ago. It was a total shock that the insomnia came back as horribly as before, only this time I couldn’t blame it on my bladder! I decided to take aggressive action. I purchased The Savvy Insomniac, and a book by Dr. Arthur Spielman. Everything I read encouraged me to try SRT again.
A Rocky Start
How much did you restrict your sleep at first, and how did you fare?
To begin SRT, I averaged my previous week’s sleep and came up with 4½ hours. I decided to stay up until 1 am and get up at 5:30. At first, I decided to stay in bed during those 4½ hours whether I was sleeping or not. My results were terrible! I alternated between zero sleep nights and 2 to 3 hours [of sleep]. Determined to force this to work, I started to get out of bed when I wasn’t sleeping. That didn’t work, either. I got an occasional 4-hour night but I was so sleep deprived [that] I didn’t feel comfortable driving at night, which was a deal-breaker for me.
You say that SRT called up lots of anxiety. Can you elaborate?
Being that regimented just threw me for a loop. I really dreaded the evenings. I would be up for hours after my family went to bed, waiting to fall asleep until the right time. For me, staying up later than the gang was . . . stressful. [And] looking at the clock, especially at bedtime, seemed to cause me stress.
Also, there was an 11-mile hike I was looking forward to in a month, and I put pressure on myself to be in good shape by then. Every day that I couldn’t . . . increase my time in bed, I would get discouraged and feel that going on the hike would be an impossibility. I also worried that health-wise it was not good to spend [such a] short time in bed for an extended period—and this was not looking to be a short-term project for me.
Rewriting the Rules
So you decided to make some changes. What were they?
The thing I discovered is I had to do [SRT] in a flexible way that worked with my environment and my personality. I decided to come up with a modified version of SRT, one I could stick with long-term.
First, I needed to be able to go to bed when my family did. . . . And I needed to start with 6 hours [rather than 4½].
I was not going to watch the clock strictly. I [would go] to bed at approximately 11:30 and get up at 5:30, but it worked best if I didn’t look at the clock.
Since even in normal times I usually had a few wake-ups an hour or 2 before it was time to get up, I vowed to get out of bed at one of these wake-ups, or at 5:30, whichever came first.
I did not put a time limit on how long I would keep up this routine, so there was no pressure to improve. I also vowed to make this a background project in my life—do my 6 hours in bed and go about the rest of my life.
How well did your modified protocol work?
I had one of my longest periods of good sleep . . . followed by some “off” nights. Then another record-long period of good nights, followed by 2 weeks of off-and-on.
Once I got past that, things improved at a quicker pace. I went a month with only 1 bad night, then a month with 3 bad nights, then, finally, a month with no bad nights. Two months into the project, I bumped up my time in bed by 15 minutes. Two weeks later, I added 15 minutes more. I’m now up to about 7½ hours’ sleep per night.
Julie’s right where she wants to be with her sleep. The way she got there–and the changes she made to SRT–wouldn’t be helpful for everyone. But my hat’s off to anyone who can take this insomnia treatment and tweak it in ways that work.
If you’ve managed a similar feat, please share your story here.