If you’ve ever experienced insomnia, intentionally depriving yourself of more sleep probably sounds like a nightmare. But in some cases sleep restriction may actually help alleviate chronic insomnia. A recent review of 20 sleep studies, published in The Annals of Internal Medicine, suggests that sleep restriction therapy is as effective as medication at reducing sleep issues.
According to New York Magazine, sleep restriction therapy is one type of CBT-I (cognitive behavioral therapy specifically for insomnia). CBT is a therapeutic strategy that focuses on helping patients change their thoughts and habits, and CBT-I encompasses a variety of sleep strategies, from relaxation training to establishing a regular bedtime routine. Sleep restriction therapy is certainly one of the less intuitive CBT-I strategies, but according to researchers, it can make a big difference.
Of course, simply forcing yourself to stay awake won’t cure your insomnia. Rather, patients undergoing sleep restriction therapy spend several weeks carefully recording the number of hours they actually sleep. Then they set a sleep schedule that mirrors hours of actual sleep rather than desired sleep. For instance, patients who sleep six hours a night, on average, would go to bed exactly six hours before they need to be awake. Then, as sleep improves, patients gradually increase the amount of time they allocate for sleep, until they’re up to a full night of seven or eight hours.
The idea behind sleep restriction therapy is pretty simple: “People get very focused on total sleep time, on how much sleep they got,” Dr. Michael Perlis, director of the behavioral sleep medicine program at the University of Pennsylvania’s Perelman School of Medicine, told New York Magazine. “And they forget what actually pisses them off is not six hours of sleep—that's not great. But waiting for sleep, being in bed at the middle of the night staring at the ceiling?That's what you want to get rid of.”
Sleep restriction therapy limits the amount of time you spend in bed to the amount of time you’re actually able to sleep. Of course, initially that probably means you’re getting even less sleep than usual, since for many insomnia sufferers, it can take hours to fall asleep. But the idea is that by tiring yourself out enough, you’ll eventually start falling asleep faster. New York Magazine explains, “You're so exhausted by the time you hit the pillow that you immediately fall into a deep sleep, so, in time, your mind starts associating your bed with actual, restful sleep.”
Sleep restriction therapy certainly isn’t the most fun technique: It can be incredibly strenuous, and though researchers vouch for its efficacy, many patients are simply unwilling to put themselves through it. Perlis explained, “The minute they find out what they’re supposed to do, that’s the end.” But for insomniacs willing to go through the program, a few weeks of sleep deprivation can mean a more restful future.