Cognitive Behavioral Therapy for Insomnia (CBT-I) is one of the most commonly used therapies for treating chronic insomnia that lasts three months or longer. And, one of the most important components of CBT-I is Sleep Restriction Therapy (SRT), developed in the early 1980s by Arthur Spielman, a psychologist and sleep specialist. The main aim of SRT is to help consolidate sleep by reducing the time spent lying awake in bed.

What is Sleep Restriction Therapy?

In short, sleep restriction therapy is a natural, alternative, non-pharmaceutical type of treatment for chronic insomnia, as part of the CBT-I protocol. The focus of SRT is not to get more sleep but to improve sleep efficiency and create positive associations between sleep and the bed.

It limits time in bed to the average number of hours spent sleeping. Why? Because most insomnia sufferers spend lots of time trying to sleep which triggers a negative psychological link between the bed and insomnia. So, SRT conditions the body to sleep for a specific amount of time without just lying in bed or napping.

By decreasing time spent in bed, the drive to sleep increases which in turn improves the ability to fall asleep fast without a long sleep latency period (the time it takes to fall asleep). That said, here’s how sleep restriction therapy can boost sleep efficiency:

• SRT increases the chance of sleeping through the night without waking up.
• SRT helps the brain create a positive association between sleep and the bed.
• SRT helps regulate the circadian rhythm and develop healthy sleep patterns.

How to Practice Sleep Restriction Therapy?

Sleep restriction therapy, as already mentioned, is a part of cognitive behavioral therapy for insomnia and is generally undertaken with the guidelines and supervision of a sleep specialist. Here’s what it typically comprises:

• The patient notes the amount of time they spend asleep during the last couple of nights and then uses the nightly average as the amount of time they are allowed to spend in bed.
• A strict and consistent sleep schedule is created meaning that the patient should go to bed and wake up at the same time every day, without exception.
• The patient is obliged to avoid naps during sleep restriction therapy, as well as to stick to the prescribed sleep period.
• Once the patient can sleep through that specific sleep period without lying awake in bed or waking up, the time increases by 15 minutes.
• The sleep period continues to increase gradually until insomnia symptoms are eliminated, sleep consolidated, and daytime sleepiness minimized.

The final goal is that sleep efficiency reaches 85%, meaning that 85% of the total time spent in bed, is spent sleeping. Yet, although it sounds quite simple, SRT requires lots of discipline and commitment to have successful results and improve sleep latency, nighttime wakening, and sleep efficiency.

What are the Side Effects of Sleep Restriction Therapy?

Finally, because SRT strictly controls the time spent in bed, experiencing some temporary side effects is also possible. Common short-term side effects of sleep restriction therapy include:

• Daytime sleepiness
• Poor focus, memory, and concentration
• Circadian rhythm disruption
• Anxiety

However, most of these side effects are already experienced by insomnia sufferers daily. Therefore, it’s not something they aren’t familiar with. Luckily, by keeping focused and committed to the protocol, they can notice improvements even after the first week.