View Full Version : Sleep restriction boosts pharmacological treatment


bluefoxicy
02-22-17, 01:57 PM
Noticed I sleep well some days, not others; and I sleep well if I stay up late. I still need Suvorexant, and frequently Melatonin (although not always!); but I still sleep poorly on those, following a normal sleep graph with interrupted sleep and large amounts of restlessness. I wake up for hours instead of minutes.

If I don't have the drugs, I don't sleep. I went 4-5 days getting 2 hours, then grabbed for one of my few remaining Suorexant pills and got a serious 8 hours. Called the psychiatrist and had them send me a refill and start prior authorization with my insurer (Eszopiclone kept me in a hypnotic state 24/7, making driving dangerous--and didn't help me sleep well anyway).

After asking some questions like, "Do I need the same amount of sleep every day?" and, "Should I just stay up later?", I poked Google and magic came out (http://sleepdisorders.sleepfoundation.org/chapter-2-insomnia/cbt-overview/cbt-sleep-restriction/).


Sleep restriction therapy aims to limit the time spent in bed to the actual time spent sleeping and to increase sleep efficiency by prolonging sleep time. Restricting the time spent in bed creates a mild sleep deprivation and can promote an earlier sleep onset, more effective and deeper sleep, and less night-by-night variability in the quality and quantity of sleep.


Essentially, I would spend 10 hours in bed (10pm-8am) getting 6h47m of sleep.

Something about sleep actigraphy before you try this.

Sleep actigraphy approximates polysomnography with 93%-97% accuracy under the correct conditions. If the patient sleeps well, then the actigraphy parameters must be less-sensitive to activity; whereas if the patient sleeps poorly, they must be more-sensitive.

If you spend a lot of time awake and your FitBit reads you as sleeping during that time, switch that reading to "Sensitive".

Now, each week, I calculate the total sleep time against the time in bed. If I'm spending 90%+ of my time in bed asleep, I move bedtime back 15 minutes. If I'm spending under 80% asleep, I move it forward 15 minutes.

This means I go to bed at midnight and get up at 7am every day. At 90% sleep efficiency, I move that back to 11:45pm and get up at 7am. Continue until efficiency begins to fall.

If you're using sleep medication, try combining sleep restriction. It works. The $50/month for Fitbit Premium makes this simpler, but isn't necessary.