By Kate Haas
What to try when all the sleep hygiene in the world isn’t working
The insomnia struck without warning, smack into my pretty good life. After easily falling asleep one night, I woke three hours later, unable to drift off again. It happened the next night, and the next. After a few days, I was exhausted. After a week I was a wreck, snapping at my kids, zoning out at work, no longer trusting myself to drive.
“Women tend to experience sleep disturbances around menopause,” my doctor said. I repressed the urge to roll my eyes. Once I hit my forties, no matter what issue brought me to the medical office, menopause always seemed to top the list of usual suspects. I left with a prescription for a week’s worth of sleeping pills and an assurance that the meds would let me rest and reset my sleep schedule.
I got some rest. But when the pills ran out, the insomnia was still there.
Four months later, by the time my doctor finally referred me to a sleep specialist, I had tried it all: melatonin, vitamins, soothing podcasts. I’d upped my sleep hygiene, banishing chocolate and wine and electronics before bedtime. I’d been screened for depression and sleep apnea. Nothing helped.
Desperately sleep deprived and deeply sceptical, I told myself I’d do whatever this sleep guru recommended. But would anything really change?
When I heard what the specialist proposed, I figured the answer was a definitive no. He wanted me to spend less time in bed — the one place I had any hope of rest. Only the three impressive diplomas on his wall kept me nodding along.
Yes, I admitted, I did lie awake in bed when I couldn’t sleep. (What else was I going to do?) And yes, I went to bed early and stayed in bed late, hoping that maybe, maybe, I would catch an extra hour.
These habits, it turned out, were only reinforcing my insomnia. Sleep, the specialist explained, needed to be compressed into an eight-hour chunk. He compared my slumber to a ball of dough, meant to be solid and firm. Too much time in bed, combined with irregular hours, was stretching the dough, filling it with holes.
Recompressing my sleep would involve following a strict behavioural plan. It might take weeks. “But it works,” he said. “The only variable is your willingness to stick with it.”
After four months of hellish sleeplessness, I was willing to stick with anything. But the plan he outlined sounded awfully counterintuitive.
I was to go to bed at the same time every evening and rise eight hours later — whether I’d slept or not. During the night, I would lie awake no longer than 20 minutes at a time. After that, I’d go to another room and read something boring. Only when I felt sleepy could I return to bed. I was to repeat this process throughout the night. Finally, I would keep a sleep log tracking bedtime, rising time, how often I woke up, total time awake during the night, and quality of sleep on a scale of one to 10.
Just contemplating this agenda made me tired — and I was already exhausted.
The glowing numerals on my bedside clock read 1:07 a.m. when I woke up on the first night of the plan. For the next 20 minutes, I lay staring at the dim ceiling. I had zero interest in leaving my warm bed and reading the boring tome I’d selected for this moment, a textbook on mammals. But I did it.
Once I felt sleepy, I padded back to bed. Twenty minutes later, still awake, I hauled myself wearily up again and back to another chapter. This continued for the rest of the night.
The next morning I recorded my total time awake: four hours, 45 minutes. What the hell? I’d been awake the exact amount of time as every other night, except now I was familiar with the mating habits of shrews. The whole process felt absurd and unproductive.
But I wasn’t about to be the variable that sabotaged the plan. So I stuck with it.
And slowly, something started to change. Filling out my log on the morning of the seventh day, I noted that I’d been up reading for several stretches during the night. But my time awake had actually shrunk. For the first time in months, I had managed to sleep for five entire hours. I was stunned. The plan was working.
My progress wasn’t straightforward; some nights I spent two or three hours with that biology textbook, learning more about marsupials than I really cared to know. But steadily, over the course of six weeks, my insomnia receded. Five months after it had struck, I was sleeping through the night again.
Later, I learned that the technique I’d used was sleep restriction, a form of cognitive behavioural therapy. According to the National Sleep Foundation, reducing the amount of time in bed creates enough extra sleep deprivation to enable better overall sleep. It also works by breaking the mental association between being awake and being in bed; and it’s considered safer and more effective than medication or other sleep aids.
The sleep plan was not easy. It demanded effort and commitment when I was almost too tired to summon either. I’m grateful that I found the strength to stick with it, and to believe, despite my exhaustion, that staying out of bed was actually the key to more restful nights in bed.
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