Professor Jason Ellis has drawn on his experience to help tackle your sleep problems. In the final part of his series, he reveals a specialist technique called sleep rescheduling that will help end your sleep problems for ever
When you have had insomnia for years, it’s very common to find yourself inadvertently stretching out your night by going to bed super-early when you get the chance and giving yourself long lie-ins as you desperately try to catch up on lost sleep.
But this is the worst thing you can do. If you have been following my plan all week, and dutifully filling in your sleep diary, morning and night then you will, by now, have a clear picture of your own insomnia. You may also have noticed things starting to improve as you work your way through all the different techniques and exercises.
But there is one unspoken problem we have yet to cover. For, if your life has been blighted by insomnia for years, it’s likely you’re spending too long in bed.
It’s a perfectly natural response to sleeplessness, and one I see every day in my practice. But it’s seriously damaging to the power of your sleep.
This is because extending the time you spend in bed makes sleep more shallow and, therefore, less potent in terms of providing adequate mental and physical rest. And the shallower the sleep, the more vulnerable you are to being woken up.
You end up ‘sleep surfing’, where you lie in bed, dipping in and out of fitful, restless sleep.
So you nap when you can, switch the alarm to snooze mode and skip nights out to go to bed ever-earlier in your attempts to catch up on lost sleep.
The key to putting an end to this destructive pattern is simple. You need to shorten the amount of time you spend in bed. It may sound counter-intuitive, but trust me on this. The idea behind so-called sleep rescheduling is that, by consolidating your sleep, you effectively concentrate and condense it to ‘thicken’ it and toughen up the vulnerability points.
It makes the dips in the night that render you vulnerable to being woken by bad dreams, distant noises or nagging worries far fewer in number, and your sleep more intense and refreshing.
It’s not easy which is one reason why I’ve left it to last. (And if you’ve been following my plan and have already dramatically improved your sleep, then you don’t need to try it.)
The aim is to achieve perfect sleep, the sort of sleep duration and quality that you might have enjoyed before insomnia blighted your life. I can’t tell you whether that will be six hours a night or eight. It’s a very personal issue, but I can help you find your perfect sleep duration, thanks to the personalised element of this plan.
And that’s where the power of your sleep diary comes into its own. That’s another reason why we’ve left this very important step to the end.
In order to truly personalise this part of the plan, I need you to have completed a week’s worth of diary entries. Do see your GP before embarking on sleep rescheduling if you have any health concerns or illnesses, and be aware, this sleep tool is not appropriate for people with bipolar disorder, psychosis or epilepsy, or if you have a history of seizures, post-traumatic stress disorder, migraine or head injury.
I need to warn you now that this is going to involve going to bed later than you probably have done for years and, that because insomnia is conditioned, you might initially wake up during the night.
This means you are likely to be even more tired during the day than normal but just for a few days. I can assure you any discomfort will be short-lived, and your life could change irreversibly for the better.
Think of it a bit like sleep training a baby and a few nights of discomfort and a few super-bleary days, but a potential lifetime of blissfully silent nights.
This isn’t actually restricting your sleep, it is merely restricting the time you spend in bed. And there are very good scientific reasons why this is a good idea.
Still not convinced? Ask yourself how long you’ve had insomnia. If you’ve been struggling with sleep for roughly three nights a week over the past two years, you’ll have had 312 nights blighted by insomnia. Are you willing to trade a few nights of re-ordered sleep now for 312 nights of insomnia in the future?
With this in mind, it is a good idea to start this when you have a couple of days without commitments, or at the weekend so you have a couple of days without having to be properly focused for work.
Start now and you can spend the weekend adjusting, but be one big step on the road to recovery by Monday.
(Be aware that this is not a decision to take lightly, and you should take special care if you need to drive anywhere or operate machinery. If you do, take a moment to work out whether this is realistically manageable for the next seven days, and perhaps delay until you can take a few days off work to focus properly on your insomnia.)
Calculate your new, later bedtime
1. Work out how much sleep you actually get each night.
At the bottom of your morning diary entry, we have asked you to calculate your ‘total sleep time’ for the night being the total time you spent in bed, minus the total time you spent awake.
Use a calculator and add together all the ‘total sleep time’ calculations you have, then divide this figure by the number of days you’ve kept your diary.
Ideally, this should be at least seven continuous days. The result will give you an average total sleep time in minutes.
This figure shows exactly how much time you are spending asleep each night. If your insomnia is bad, you might be shocked to see how little sleep you are getting. All the more reason for you to be doing this!
If your average total sleep time works out at less than five hours, it’s a sign that you really are having a tough time. No matter how low your average total sleep time is, never try sleep rescheduling on less than five hours (300 minutes) per night.
2. Set a firm, unchangeable morning wake-up time. Think long-term: this will be the time you set your alarm and the time you get up for the foreseeable future weekends and holidays included because this is the best way to anchor the circadian rhythm, which controls when you wake and when you sleep.
Most people set this as the time when they need to get up and get ready for work, or get the children ready for school.
Even if you don’t work or you’re retired and have no morning commitments, it’s important to set a non-negotiable wake-up time that works best for you.
3. Work out your temporary new bedtime. To do this, take your total sleep time (the average of all your calculated sleep times) and count backwards in minutes from your new, set wake-up time.
So, if you decide that, from now on, your morning alarm will go off at 7am and your sleep diary reveals you average six hours’ sleep per night (360 minutes), your new bedtime for the period of this sleep rescheduling exercise should be 1am.
Do not, under any circumstances, factor less than five hours in bed.
The sleep diary and your preferred wake-up time mean this is a completely individual calculation, but you are very likely to find that your new bedtime is a lot later than you imagined. Trust me here and stick with this.
Any compromise now will significantly dilute the impact of this very powerful technique.
4. Stick to your new schedule, going to bed at your temporary new bedtime and getting up when your alarm goes off with no deviation for seven nights, and keep religiously filling in your sleep diary while you do so. I urge you not to buckle or even think about adjusting your new bedtime. Bringing it forward even by a few minutes will produce a watered-down effect.
Remember, you’ve done the calculations and you know how much total sleep you get each night. Even if your new bedtime seems horribly late, you will still be getting exactly the same amount of sleep as you were before.
However, it may take a few days for your body and brain to adjust to your new concentrated sleep regimen.
In the first few days, if you still struggle to fall asleep, or you wake up in the night, you’ll find you have to function on a little less sleep even than normal. Keep yourself and others safe, and keep the faith. This is only short-lived.
Studies have repeatedly shown that this method really does work. Very swiftly, your body and brain will be forced to accept that bed means sleep the minute your head hits the pillow. Just as important, your sleep will be deep and refreshing.
Would you prefer six hours of really good quality sleep or eight hours of really poor quality sleep?
5. No napping, no compensating, no catching up at weekends. The only exception to this rule is if you feel so sleepy during the day that you absolutely need to sleep. This could be a sign of other health issues and you must see your GP before continuing.
However, most people report that, at first, sleep rescheduling has very little impact on their overall levels of tiredness, since they’re getting exactly the same amount of sleep as they always did.
Indeed, you should very soon start to feel better fresher, more alive and optimistic than you have for a very long time, because your sleep will be consistent, deep and good for the first time in years.
Every night you get it right falling asleep within minutes of going to bed, sleeping through the night and not waking up ahead of your alarm, you will be sending positive reinforcement messages to all the subconscious mechanisms that have been keeping you awake at night for so long without you realizing.