[sablana]

Hi dear friends,
I finally started my group CBT-i and I am terrified. I introduced myself here a few months ago.
I was prescribed CBT-i to help me sleep longer and to get off sleeping aids (Unisom mostly). I did sleep diary for 9 weeks before the first group session and on average week I slept around 6hr 15 min and sleep efficiency was around 87%. I spent in bed 7 hr 10 min. However I feel tired and sleep deprived on that amount of sleep. I got prescription to restrict time in bed to 6hr 30 min. Today is day 5 of my “restricted sleep”. Out of prescribed 6 hr 30 min in bed I slept on average 4hr 15 min for the last 5 nights. The rest of the TIB I was in the “wait to get sleepy area”. Thus my sleep efficiency dropped to 63%. I stopped training completely which I normally do 90 minutes a day. Today I went to the library and fell, I do not coordinate my body very well. Luckily I did not hit my head or knee but injured left foot. Hope it is not a fracture but will see tomorrow. I am still taking the same amount of sleeping meds, but altered the schedule and need to go and wait until I get sleepy when I wake up at night. I just don’t see the goal of depriving myself even more … Or should I keep going .. My next session in 10 days and the therapist does not respond to my email. Throw some wisdom at me please. Thanks

[Martin Reed]

Hello Sablana

First of all, if you were averaging a sleep efficiency of 87%, I am very surprised that you were advised to reduce the amount of time you allot for sleep. Most of the time, it is suggested that at around 85% sleep efficiency we maintain the current sleep window and above 85% sleep efficiency, we look to slightly extend it.

If you were averaging 6 hours and 15 minutes for sleep, and were given a sleep window of 6 hours and 30 minutes, this suggests your therapist was looking for you to reach a sleep efficiency of over 95% which would be extremely high, even for someone with no problems with sleep! That’s because it’s normal for it to take time for us to fall asleep at the start of the night and it’s normal to spend some time awake during the night.

It’s important to bear in mind that sometimes sleep can initially become worse when you start to implement CBT-I techniques — but if you ride out the short-term pain, you will usually start to notice improvements.

Have you heard back from your therapist yet? Why do you feel that the shorter sleep window (which was still longer than your average nightly sleep duration) led to significantly less sleep?

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