What is sleep-restriction therapy for insomnia?

Updated: Sep 11, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Sleep-restriction therapy is based on the fact that excessive time in bed often perpetuates the insomnia. Limiting the time spent in bed leads to more efficient sleep that is both consolidated and more regular and predictable. Time in bed is allowed to increase as the patient demonstrates a continuing ability to sleep in an efficient and consolidated manner.

This treatment plan consists of limiting time in bed to the patient's estimated total sleep time (not less than 5 hours) and increasing it by 15-30 minutes for a given week when the patient estimates that his or her sleep efficiency (SE; ratio of time asleep to time in bed) has reached greater than 85%. The amount of time in bed remains the same when the SE falls between 80 and 85% and is decreased by 15-30 minutes for a given week when the SE is less than 80%. Periodic (weekly) adjustments are made until the optimal sleep duration is achieved.

Use sleep-restriction therapy with caution in patients with occupations for which sleep deprivation can have devastating consequences. These include commercial truck drivers, operators of heavy machinery, and pilots.


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