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What is Sleep Restriction Therapy? Does it Work? | Treatment for Insomnia

What is Sleep Restriction Therapy? Does it Work? | Treatment for Insomnia

Understanding Sleep Restriction Therapy

Sleep restriction therapy (SRT) is a non-pharmacological approach used to treat chronic insomnia and other sleep disorders. The core idea behind SRT is to limit the amount of time spent in bed to improve sleep quality and increase sleep efficiency. By restricting the time spent in bed, individuals can start to associate the bed with sleep rather than wakefulness, leading to better sleep outcomes. Often used in conjunction with cognitive behavioral therapy for insomnia (CBT-I), SRT can be an effective treatment for insomnia disorder. This method helps to recalibrate your sleep schedule, making it easier to fall asleep and stay asleep through the night.

How Sleep Restriction Therapy Works

Sleep restriction therapy is a common feature of virtually all types of cognitive behavior therapy for insomnia (CBTi). It aims to address difficulty staying asleep through reverse logic. Limiting the amount of time spent in bed can actually help those struggling with sleeplessness to sleep better.

This sounds strange, right? Read on to learn about sleep restriction therapy, how to utilize this method, and how it helps treat insomnia disorder.

It was developed by Dr. Arthur Spielman a neurologist and specialist in sleep medicine from New York. Since then, decades of sleep research have proven it to be the most effective technique for improving sleep. It is considered a reliable treatment method for those with insomnia, and for anyone who is simply trying to sleep better.

The name of this method may be confusing because the goal is not to restrict sleep, but rather to restrict time spent in bed awake. The main concept is that the more time insomniacs spend in bed, the less time they spend asleep. Sleep restriction is designed to correct this imbalance.

Sleep Restriction Therapy Steps

This CBTi method works to increase your sleep efficiency. Average sleep efficiency scores are calculated from sleep diaries, indicating the percentage of time spent asleep compared to time in bed, and this information is used to adjust sleep windows as needed.

  1. Record Your Sleep Patterns – Keep a sleep diary or use a sleep tracking app for at least two weeks. This will help you better identify your sleep habits and patterns.
  2. Average the Hours of Sleep per Night – Using your sleep log, you will need to find the average number of hours of nightly sleep.
  3. Set Your Bedtime – Start by going to bed in time to achieve only the average number of hours that you calculated. For example, if you usually only sleep 6 hours, and you need to wake up at 7:00 am, then your initial bedtime should be 1:00 am. It is recommended, however, that you do not restrict the sleep time less than 5.5 hours even if that is more than your average sleep time.
  4. Maintain the Same Wake Time – Keep the same wake time every day of the week.
  5. Stick to this Schedule for at Least Two Weeks – The time spent in bed should not vary according to the amount of sleep you got during the night either.
  6. Increase the Time Spent in Bed – When you are sleeping relatively well through the night and starting to feel tired during the day, gradually increase the time spent in bed. Move back your bedtime by adding 15 minutes each week.
  7. Find Your Ideal Bedtime – You will know that you have reached your ideal bedtime when you are sleeping better through the night and feeling rested during the day.

Benefits of Sleep Restriction Therapy

Sleep restriction therapy offers several notable benefits for those struggling with insomnia disorder:

  • Improved Sleep Efficiency: By limiting the time spent in bed, SRT helps increase the proportion of time spent sleeping, thereby reducing sleep fragmentation and improving overall sleep efficiency.
  • Increased Sleep Quality: SRT can help individuals fall asleep faster and maintain sleep throughout the night, leading to a significant improvement in sleep quality.
  • Reduced Daytime Sleepiness: As sleep quality improves, individuals often experience less daytime sleepiness and fatigue, making it easier to stay alert and productive during the day.
  • Non-Pharmacological Approach: SRT is a drug-free method, making it a safe and effective treatment option for those who prefer to avoid sleep medications.
  • Long-Term Results: One of the most compelling benefits of SRT is its potential for long-term results. Studies have shown that improvements in sleep quality can last for several months after completing the therapy.

Does Sleep Restriction Therapy Work?

Sleep restriction works for most people with chronic insomnia. Though you may not reach the mythical 9 hours of sleep that is recommended, it can help you find the right amount of sleep for you. A few extra hours of quality sleep each night can make a world of difference to anyone feeling constantly tired and unrested.

Like all CBTi techniques, sleep restriction therapy is drug-free. It works by increasing sleep efficiency – the amount of time spent awake in bed versus sleeping – and eliminating prolonged awakenings in the middle of the night. Sleep restriction can also help you to look forward to bedtime and can provide a long-term solution for better, less fitful sleep patterns.

Common Challenges and Limitations

While sleep restriction therapy can be highly effective, it does come with some challenges and limitations:

  • Initial Sleep Deprivation: At the beginning of SRT, individuals may experience initial sleep deprivation, which can be difficult to manage.
  • Daytime Sleepiness: The first few weeks of SRT can lead to increased daytime sleepiness as your body adjusts to the new sleep schedule.
  • Difficulty Sticking to the Schedule: Adhering to the strict sleep schedule required by SRT can be challenging for some individuals, potentially reducing the therapy’s effectiveness.
  • Limited Research: Although SRT has proven effective for treating insomnia disorder, there is limited research on its application for other sleep disorders.
  • Not Suitable for Everyone: SRT may not be appropriate for everyone, particularly those with certain medical or mental health conditions. It is crucial to consult with a healthcare professional before starting SRT to ensure it is a suitable treatment option for you.

By understanding these challenges and limitations, individuals can better prepare for the therapy and work closely with their healthcare providers to achieve the best possible outcomes.

How Long Does It Take?

Sleep restriction therapy works for a lot of people with sleep disturbances, but it takes time. It generally takes several weeks of diligence. For this method to work well, it is important to stick to the schedule and the very gradual time extensions.

Sleep Restriction Therapy Tips

Here are some quick tips for success in overcoming insomnia.

  • Plan a strong start to your day. When the alarm goes off at your set wake-up time, go through your normal routine while adding some habits that signal to your body that it is morning. This could include opening the shades, turning on bright lights, taking a shower, or going out for a walk.
  • Resist the urge to take naps. Sleeping during the day will make sleep restriction less effective. It is better to avoid naps to ensure that you will be tired and looking forward to bed at the right time. Exercise and spending time outside can help shake off the drowsiness.
  • Continue using your sleep diary or app throughout the therapy process. This will help you and your doctor to adjust your schedule as needed.

Related article: 10 Scientifically Proven Ways to Fall Asleep Faster

For more information about treatment options for sleep disorders, contact Sleep Health Solutions.

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