[elizanndixon]

Hi there,

I’ve been struggling with insomnia for over a year now, and am getting to the point where I feel like I’ve tried just about everything.

One of my methods involved sleep restriction, and I’m currently seeing another specialist who has recommended this. However, ever since starting the sleep restriction in its entirety about 3 weeks ago, my sleep has actually worsened. My window of time was initially set for 6-12 am, but my sleep efficacy remained lower than 85% and even got worse. I’ve since reduced it to a 5 hour window, 1-6, and even then I am unable to fall asleep quickly. For the past few nights I’ve tried staying up even later, but find that after a period of time, my body feels so tired that it feels physically “stressed” , which then inhibits sleep even more. My tract record for the past week has been a sleep time of 2ish am – 6am.

I see my sleep specialist again next week to follow up, but I’m just feeling really frustrated. Isn’t sleep restriction supposed to be making things better, not worse? Is it normal for things to get worse before better? How short would you recommend I make my sleep window? Is it unsafe to limit it to 4 hours? Or should I stay at 5 or 5 & 1/2?

Thanks so much for all you do!

[Martin Reed]

How are you getting on since you posted? It’s not uncommon for sleep to actually get a bit worse when you first implement sleep restriction, due to the novelty of a new sleep schedule.

I don’t usually suggest observing a sleep window of less than five to five-and-a-half hours because you want to give yourself the opportunity to get at least a certain amount of sleep.

Are you consistently getting out of bed by the end of your sleep window? When you get into bed at the start of your sleep window and find it hard to fall asleep, have you tried getting out of bed?

There is more to cognitive behavioral therapy for insomnia (CBT-I) than sleep restriction alone — so I’m hoping that you are implementing other techniques such as stimulus control to give you the best chance of success.

You might find this video helpful: Why the process of getting rid of your chronic insomnia is like turning a giant flywheel.

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