Are Sleep Restriction and Getting Out of Bed Really Useful Techniques for Curing Insomnia?
Almost all sleep specialists give people with insomnia at least one of these two recommendations: either restrict your sleep or get out of bed when you can’t sleep. Sleep restriction has the goal to shorten the amount of time spent in bed to consolidate sleep, so you sleep more deeply. And getting out of bed when you cannot sleep is supposed to help you associate the bed exclusively as a place to sleep and not as a place where one lies awake.
There is no question that these methods have proven to be useful for some people with insomnia. Still, it has been my experience and that of many others that using sleep restriction or leaving your bed alone isn’t always a viable long-term solution for the real challenge you face: effectively dealing with anxiety and the racing thoughts at night that are keeping you awake.
If the root cause of your insomnia is psychological, it cannot be solved by simply changing your sleep pattern, but only by changing the way how you respond to your unhelpful thoughts, emotions, and sensations.
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That said, using both or one of the two methods moderately can contribute to developing healthy sleep habits, which in turn helps you to calm down and creates a good foundation from which natural sleep can emerge. So let us take a closer look at these methods.
Why sleep restriction helps to improve your sleep efficiency
Some people spend 10 hours in bed to get 6 hours of sleep. They take a long time to fall asleep, and their sleep is very fragmented, often waking up every hour.
The fact is that spending too many hours in bed weakens your sleep drive. If the average time you spend in bed is far apart from your total sleep time, then sleep restriction may be necessary and helpful to improve your sleep efficiency and increase your sleep drive by reducing the amount of time you spend in bed.
Keep in mind that sleep restriction doesn’t aim to limit the actual sleeping time, but the time spent in bed.
How to proceed with sleep restriction?
In my experience, to keep anxiety levels low, it is best to take a step-by-step approach to reduce the time spent in bed rather than a hard cut of only 6 hours (e.g., from 12:00 to 6:00 in the morning), which some sleep experts advice.
For example, you can start by going to bed 15 minutes later and setting the alarm 15 minutes earlier. After two or three days, you can then take another 15 minutes off the bedtime in the evening and in the morning. You do this until you have reached your ideal sleeping time.
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However, keep in mind that bedtime should never be less than 5.5 hours, even for people who sleep less than 5.5 hours per night.
What is the aim of distractions like getting up in the night?
The other advice that many sleep therapists give is to get up if you are awake in bed for more than 15 minutes. The recommendation is to go to another room to do something calming and soothing, such as reading, listening to music, or meditation until you are sleepy enough to go back to bed.
The aim of this method is to associate the bed exclusively as a place to sleep and not as a place where one lies awake. It is also hoped that getting out of bed and distracting yourself from your thoughts and emotions will help reduce anxiety and increase the degree of drowsiness to quickly fall asleep after getting up.
If you have used a technique where a brief distraction such as getting out of bed to engage in a simple, trivial activity has helped you calm your mind and put you to sleep, then that’s great. For example, I always have a book on my bedside table, and often a few pages of reading are enough to make me sleepy.
That being said, this distraction technique works because I am a normal sleeper now. While I was suffering from insomnia, reading a few pages in a book or leaving the bed wouldn’t solve my actual sleep problem which was my continuous struggle with my racing mind and anxiety.
Why getting out of bed can be an unhelpful avoidance strategy
Just like other unhelpful coping strategies, leaving bed can become an avoidance strategy to avoid dealing with difficult thoughts, emotions, and sensations. Instead of staying in bed and giving these thoughts and emotions some space to allow them to move, you distract yourself by getting out of bed.
But what happens when you go back to bed? Exactly, these terrible thoughts and emotions are then often back as if they had been waiting for you. The distraction offered only a short relief that keeps you caught up in your struggle with these unpleasant experiences and further increases your alertness.
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In some people, getting up may even lead to the unhelpful new association that the night is about getting up and doing something instead of resting. Therefore, getting up often solves the problem in the short term but is not a sustainable long-term solution to overcome your anxiety and worries.
How to deal with the urge to leave the bed?
I firmly believe that the most practical way to build a helpful relationship with your sleep is to gradually learn how to be in bed with your fears instead of getting out of bed and escaping them. When you know how to better deal with your anxiety in the middle of the night you nay no longer feel the need to get up and distract yourself.
However, if you have escaped from your bedroom in the middle of the night to deal with your insomnia, the decision to stay in bed may feel like the worst thing ever. If this is the case for you, it may help gradually adjust to it because there is no point lying in bed, rigid with fear and anxiety. The goal is to gently increase your willingness to be quietly awake so that you can easily enter the pre-sleep phase like a normal sleeper.
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If you feel a strong urge to get out of bed, it can help you sit on the edge of the bed for a few minutes. This can create a certain spatial and mental distance between you and the bed and give you a feeling of relief.
It also allows you to gain objectivity and clarity about what’s going on in your mind and body. Use this break as an opportunity to practice some mindfulness exercises so that you can achieve this objectivity and let go of your judgment. If you repeat this exercise more often, it can help you break the cycle of needing to leave the bed altogether.
Keep it brief and non-stimulating
If you feel that you really need to leave the bedroom, do so, but keep it brief and not stimulating. Avoid doing anything productive that makes you feel like “Great, I’m getting things done” because that reinforces the habit of waking early. Also, keep your TV, computer, and phone off, and leave work alone. Your to-do list and social media can wait.
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In the beginning, it can be helpful to have a plan of how long you want to stay in bed with your insomnia each night before you get up for a break. Try to gradually reduce the time you spend out of bed and the frequency of getting up each night. People who have taken this approach have found that they can increase the amount of time they spend in bed quite quickly and notice improvements in their energy levels.
What is your experience with sleep restriction or getting out of bed? Did any of these methods help you improve your sleep? I’d love to hear your feedback!