[Saeng Ggul]

Hi,

I’ve been working on restriction sleep therapy that my bedtime window is from 12 to 6. However, I always struggle to be awake until 12 and I can barely keep my eyes open watching tv. The problem happens when I eventually go to bed and lie down as I immediately feel alert with anxiety and it throws me off for the rest of the night.

Should I go to bed when I am tired but keep the wake up time consistent? I am worried that I will still wake up in the middle of the night and won’t be able to fall back asleep.

Any advice or experience you would like to share? Greatly appreciated.

[Martin Reed]

Your experience is a typical symptom of conditioned arousal — you are recognizing sleepiness when there is no pressure to sleep because it’s not time for bed yet. However, when bedtime arrives and you get into bed, your body prepares you for a difficult night because it has experienced so many of them in the past. This leads to a feeling of being wide awake and the loss of sleepiness cues.

Ultimately, the only way you can retrain yourself to see the bed as a place for sleep rather than wakefulness is to get out of bed when you are in bed, awake, and feeling worried, anxious, frustrated, or highly alert. Return to bed when you feel calm and relaxed and see what happens. You may need to repeat the process many times during the night, especially in the short term.

When you combine this technique (part of stimulus control therapy for insomnia) with an appropriate sleep window you will be building sleep drive. If you only allow yourself to sleep during your sleep window and in your own bed, this is when and where you will sleep.

Over time, you will associate your bed with sleep and this will prevent you from feeling wide awake as soon as you get into bed.

I hope this helps!

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