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In
my 4-year-long quest for rest, I thought I'd tried everything: herbal
supplements, yoga poses, Sleepytime tea, 360-thread-count sheets, imagery,
deep breathing, feng shui-ing the bedroom, alcohol, no alcohol, firm
pillows, fluffy pillows, no pillows, four pillows. Trying to sleep less
never crossed my mind. But according to a growing number of experts,
including Edward Stepanski, PhD, director of the Sleep Disorder Service at
Rush-Presbyterian-St. Luke's Medical Center in Chicago, simply limiting my
time in bed could help.
Stepanski's
version of sleep restriction is a type of cognitive-behavior therapy (CBT)
that teaches different ways of thinking about and dealing with the problem.
The idea is to cut down on the time you spend lying awake in bed so that
eventually all you do there is sleep. The goal: uninterrupted rest, even if
it's only a couple of hours. "When your sleep is broken up, you feel
lousy," says Stepanski, who is chairman of the Behavioral Sleep
Medicine Committee of the American Academy of Sleep Medicine, the folks who
set the standards for treatment of sleep disorders. Most people who have
trouble sleeping make the mistake of staying in bed too long—turning in
early, tossing fitfully, trying to doze off, or repeatedly hitting the
snooze button. "If you can teach your body to get 7 hours of sleep out
of 7 hours in bed, you'll feel better than if you have 7 hours of sleep out
of 10 hours in bed," Stepanski says. The theory holds that if you can
keep your body slightly deprived, you can increase your ability to sleep
soundly. "Cutting back on your time in bed is the most effective change
insomniacs can make," he says.
Lured
by the chance of sleep success without pills, I scheduled a meeting with
Stepanski. At his request, during the 2 weeks before my appointment, I
recorded my every waking (and sleeping) moment. Some nights I slept 7 hours
straight, but usually I woke up at 2 a.m. and struggled to get back to
sleep. I made up for the deficit by taking naps during the day, but I never
really felt rested, and I worried about sleeping (or not) morning, noon,
and, well, night.
During
my first appointment, Stepanski reviewed my logs. His diagnosis: primary
insomnia, or sleeplessness caused by stress. Tracking my energy levels, he
determined that I functioned best on 7 hours of sleep. Since I wanted to get
up at 7 a.m., Stepanski set my bedtime at midnight—no crashing earlier
even if I was tired. The rest of his 6-week plan involved following the
basic ground rules of what the experts call good sleep hygiene: no work
after 10:30 p.m., no sedating medication of any kind (even over-the-counter
aids were out), no snooze button, and no naps. Also key to success was
keeping a sleep log. It sounded simple enough, but I knew it
wouldn't—couldn't—be that easy. And it wasn't. Just take a look at how
my 6 weeks went.
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