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Sleep is a struggle for roughly 15% of all adults.  Trouble falling asleep or falling back to sleep lead many insomnia sufferers to resort to medication(s) of some sort, be it prescription or over the counter (OTC), or alcohol.

I’ve always thought that physical fitness is a good analogy to sleep health.  People do fitness training to stay in shape, that is, to make themselves stronger.  Although perhaps not completely “effortless”, physical tasks become easier with fitness training.  Stairs become easier to climb, getting in and out of cars easier, walking, running, etc.  Everyone is different.  Training is something done to make doing other things require less effort, and sleep training is no different.

Most “better sleep” programs involve time-tested behavioral changes.  For example, consume less caffeine, avoid alcohol, learn relaxation techniques, and reduce light exposure at night.  Also learning to associate the bed/bedroom only with sleep (not bill-paying, watching TV, etc.).  Some of the more cognitive (mental) suggestions are also important, such as learning to deal with worry and anxiety.  But one of the more successful approaches to insomnia is a type of sleep training called “sleep restriction” (SR).

The reasoning behind SR is that a person with trouble falling to sleep or back to sleep (or depends on medication for either) usually spends too much time in bed awake.  The associated tossing and turning result in more frustration/anxiety/worry about sleep, thus keeping the insomnia going.  With SR, the person with insomnia is asked to temporarily reduce (or restrict) how much time she spends in bed.  The typical scenario has the person, for a week, only spending about as much time in bed as she has been actually sleeping.  For example, if she has been going to bed around 9pm and getting up at 7am (10 hours in bed), but only actually sleeping about 6 of those hours, doing SR would have her only spending about 6 hours in bed each night (1am – 7am) for a week.  Should falling asleep (or back to sleep) become a bit easier (more effortless), she would give herself a bit more time (15-20 min) in bed the next week, and so on.  Should sleep not improve, she would continue with the restricted time in bed.  Daytime napping is usually discouraged during SR.

In the short run, SR can be challenging.  Asking someone struggling with insomnia to purposefully deprive him or herself of sleep is a tough sell.  Clinically, most reports of SR show 2-4 weeks before sleep becomes easier.  This can feel like eternity to a person not getting enough sleep.  Not surprisingly, SR is difficult to do on one’s own, and should be discussed with the doctor before embarking.  Some people doing SR may benefit from being in a support group.

Thankfully, the Sleep On Cue app can help greatly with SR.  Implicit in SR is a later “prescribed” bedtime.  In the example above, the person started by delaying her bedtime from 9pm to 1am the first week.  A logical question from someone is doing SR is, “What should I do while waiting for my later bedtime?”.  TV use is discouraged, and some people struggle to keep awake reading or doing puzzles late into the night, and may ultimately succumb to falling asleep on the couch.  Doing some sleep training with the Sleep On Cue app leading up to the prescribed bedtime can enhance SR, ultimately reducing the time it takes to work.  Many app users have ended their chronic insomnia in just 2-3 nights of sleep training, much faster than the usual 2-4 weeks of simple SR.  The Sleep On Cue app improves ability to fall asleep by increasing awareness of sleepiness, something sorely lacking in someone with insomnia.  The Sleep On Cue app uses a modified version of Intensive Sleep Retraining, shown in sleep lab studies to reverse insomnia as well as traditional behavioral sleep therapy.

So if you are going to do SR for your insomnia, consider adding some sleep training with the Sleep On Cue app.  Effortless sleep might not require so much, well, effort!

~ Michael