Dr Neil Stanley Independent Sleep Expert
BACK Interestingly none of these papers actually speak about the promotion of Slow Wave Sleep, nor SWS being “highly efficient nor about seeking to promote it at the expense of REM and other stages of sleep. Arthur J. Spielman, Paul Saskin, and Michael J. Thorpy, ‘Treatment of Chronic Insomnia by Restriction of Time in Bed’, Sleep, x (1987); here  William K. Wohlgemuth and Jack D. Edinger, ‘Sleep Restriction Therapy’, in Kenneth L. Lichstein and Charles M. Morin (eds.), Treatment of Late-Life Insomnia (Thousand Oaks, 2000); Shneerson, Sleep Medicine, 172. Sleep restriction Many subjects with insomnia try to compensate for this by spending more time in bed to provide enough opportunity for sleep, and particularly by staying in bed trying to sleep while this is difficult. This not only induces abnormal circadian rhythms, but also causes frustration. Sleep restriction assumes that sleep deprivation will lead to deeper and more continuous sleep which, in turn, will reverse the negative conditioning which  perpetuates insomnia. Sleep restriction techniques reduce the time in bed in order to increase sleep efficiency. A sleep–wake diary is kept and the initial time spent in bed should represent the average time asleep or felt to be asleep, but not less than 4.5 h. This is gradually increased as long as the subjective sleep efficiency remains  above 80–85% for five nights in every seven. A constant awakening time is adhered to irrespective of the time of going to bed. Fifteen to thirty-minute increments of sleep time are usual and no daytime naps are allowed.  There may be an initial worsening of daytime sleepiness but this gradually improves over a period of months. BACK
© Dr. Neil Stanley 2013-2018