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Removing the Shroud of Mystery from CBTI, Part II: Sleep Restriction

In Part I we introduced SleepRate’s “secret sauce,” CBTI (Cognitive Behavioral Treatment for Insomnia), the exclusive, Stanford-developed program we use to improve people’s sleep, and discussed how it uses Stimulus Control to establish the bed as a cue for sleep. This week we’ll discuss another important aspect of the CBTI: Sleep Restriction.

While Stimulus Control for the most part jives with what most of us already suspect about sleep, the Sleep Restriction portion of the program might seem a little counterintuitive at first, because it initially directs you to sleep less…or rather, to spend less time in bed, so that you can eventually sleep more.

Sleep Restriction: one step back, 2 steps forward

This behavior is designed to eliminate prolonged middle of the night awakenings by reducing the time in bed. For example, consider a person who goes to bed at 11:00 p.m. and gets up at 8:00 a.m. (9 hours in bed), but actually sleeps on average only 6 hours per night. During the first step of Sleep Restriction a person will be advised to be in bed for only the amount of time that they spend sleeping — in this case, only 6 hours (e.g., midnight to 6:00 am). Bet your parents never told you to do that!

Early to bed, early to rise? Not quite yet…

That’s right, you might be told to go to bed later. This sounds harsh, and definitely runs counter to the “early to bed, early to rise” aphorism. But, keep in mind that the goal here is to train the internal functions that govern sleep. By increasing the likelihood that you’ll actually be asleep the whole time you’re in bed, you’re training yourself to sleep more efficiently. After a week or so of doing this, there will be a marked decrease in time spent awake in the middle of the night.

You’ve achieved sleep quality, now increase the quantity

Usually people experience notable improvements in the quality of sleep after a week of restricted time in bed, but they also feel the effects of not getting enough sleep. The next step, therefore, involves gradually extending the time spent in bed by 15 to 30 minute increments. This is a slow and careful process designed to increase sleep quantity, while retaining the quality. So, with each increment, you’ll ensure that wakefulness in the middle of the night remains minimal, and allow at least a week before moving on to the next extension, gradually progressing to the proverbial “Good Night’s Sleep.”

How Will SleepRate Help You?

Next, in part III of this series, we’ll discuss how CBTI helps you reduce sleep-interfering arousal. If it all sounds complicated, don’t worry. SleepRate’s app 100 percent personalizes the process for you, and guides you through it every step of the way.

 

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