[Steve]

Martin,

I have two questions for you. The first is, I understand the 30/30 rule. But what if after 30 minutes I really don’t feel sleepy but I also don’t want to stay up any longer? Can I go back to bed to give sleeping a shot and then get out of bed again if after 30 minutes I can’t get to sleep? Or is better to stay up until I feel sleepy, which I may not feel until some time. I ask because quite honestly, sometimes I don’t know if I’m sleepy or not. I might miss the signs or there aren’t any.

My second question is this. I know you said it is normal to wake up during the night and that normal sleepers just go back to sleep. But have any studies been done to see the normal amount of times people wake up during the night? I ask this because sometimes I wake up very little, or I don’t remember doing so, but other times it seems I wake up every 30 to 45 minutes.

Thanks.

[Martin Reed]

Unfortunately, I don’t know of any studies that have compared the effectiveness of stimulus control techniques when implemented based solely on the estimated time someone has been in or out of bed compared to getting in or out of bed based solely on how awake or sleepy you feel.

I would suggest starting by estimating roughly half an hour when you are out of bed before returning to bed and repeating the process. If, after a couple of weeks of consistent implementation you aren’t noticing that you are finding it any easier to fall back to sleep when you wake during the night, shift your strategy to one of not going back to bed until you feel sleepy enough for sleep again.

Regarding your question about a “normal” number of nighttime awakenings — I sought advice on this from a couple of sleep experts who have a lot of experience looking at overnight sleep lab data and working with patients in a sleep setting. As suspected, they reported that there is no established normal here — but they did share some observational data that sounds realistic to me.

First, recognize that there’s a difference between an arousal and an awakening. An arousal is “an abrupt shift in EEG frequency for at least three seconds, preceded by at least 10 seconds of sleep”.

For arousals, 10 per hour would not be unusual.

An awakening is defined as something like 30 to 60 seconds of wakefulness. If we’re going to remember an awakening, these are the ones we’re most likely to remember (most people without any sleep complaints don’t even remember these because they pay no attention to them). In this case, 10 to 15 awakenings during the night would be pretty typical.

I will add that it’s important to note that these “normal” awakenings are awakenings that are expected and are part of sleep — they don’t cover awakenings caused by apneas (pauses in breathing that may require medical intervention).

I hope this helps, and thanks for the great questions!

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[Steve]

Thanks Martin.

[Author]

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