The most common treatment for insomnia involves improving sleep hygiene, which refers to behaviors such as reducing caffeine intake, only using the bed for sleep, etc. Improving sleep hygiene is effective for most people. However, it does not curb insomnia for everyone. If you have tried improving your sleep hygiene and have found it to be ineffective, you may be a candidate for sleep restriction therapy.
Sleep restriction therapy is a dramatic way to regulate your sleep. Research has shown it to be more effective than sleep hygiene alone. The catch is that it can be unpleasant, as it involves initially severely limiting your sleep. People usually opt for this form of therapy when other traditional measures have failed. Most people who undergo this more extreme intervention report they do so because they are already sleep deprived, and that they might as well be sleep deprived for a good reason.
Sleep restriction therapy was developed around the notion that people who have severe insomnia need to retrain the brain to adjust to a circadian rhythm. This along with good sleep hygiene results in significantly more sleep that lasts. Sleep restriction therapy is made up of the following components:
Sleep Restriction: This involves going without sleep for a full 24 hours. This is of course the most difficult step, but is important in that it is one of the more powerful interventions to reestablish circadian rhythms. After a full 24 hours without any sleep, people usually have little difficulty falling fast asleep the moment their heads hit the pillow.
Calculate “Time-In-Bed” (TIB): TIB refers to calculating how much sleep you have averaged in the past week, and limiting the amount of time you allow yourself in bed to no more than 30 minutes more than your average. For instance, if you averaged five hours nightly the previous week, you should allow yourself five hours and thirty minutes in bed. This can also be difficult, as this is a hard rule that must be followed no matter how tired you are.
Gradually increase the TIB: Every night thereafter, add 15 minutes per night to the TIB formula by setting your bedtime 15 minutes earlier.
Set a standard TIB: Once you feel less fatigued and more rested during the day, stop increasing the TIB. This can also be a difficult step, as many people resist the notion that they may not actually need eight hours of sleep to be well-rested. Some people need significantly less. In fact, it is often this idea that causes insomnia in the first place, causing people to spend more time lying in bed than they actually need.
Sleep restriction, combined with effective sleep hygiene can be a relatively quick and drug-free remedy for insomnia, lasting only 4-6 sessions. As with most interventions, it is important that you consult with a qualified cognitive behavioral therapist before trying any of these techniques on your own. Click here for more information about cognitive behavioral therapy for insomnia.
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