Dr. Matt Walker

would be try to think about limiting your time in bed.

If you are struggling with sleep, this is something that is used in probably the most well-validated psychological intervention for insomnia, and it's called Cognitive Behavioral Therapy for Insomnia, or CBTI for short.

What happens is that you work with a clinician, they interview you, they assess all of the reasons that you may not be sleeping, and then they create from their toolbox of many different options, a bespoke, tailored sort of Savile Rose Soup prescription for you, for your treatment.

If you look at the studies of that collection of different tools in the CBTI box for intervention of insomnia, and you ask, of all of those, which seems to carry the greatest impact on insomnia, which has the greatest sort of gravitas?

It seems to be this thing that we call bedtime rescheduling.

It used to be known as sleep restriction therapy, but obviously if you come to me and you say, look, I'm not sleeping very well, I've got insomnia.

I say, I understand, and I've got a treatment for you.

It's called sleep restriction therapy.

And you say, no, no, no, you didn't understand.

I'm not getting enough sleep, but it's not quite that.

Here's how it works.

If you are spending so much time in bed, too much time in bed, you are not forcing your brain to be efficient.

And by way of constraining your sleep window, even to, let's say, five hours a night to begin with,

I brute force ruthless efficiency from your sleeping brain after several days.

So another analogy would be, let's say you're trying to make a nice thin crust of pizza base and you put the dough on the table and you start rolling it out.

If you roll it too thin, it starts to get gaps and holes in it.

Why?

Because you've spread it out too far, and you've started to create these absences.

That's the same thing that happens, and it's very natural.

As an insomnia patient, you would say, I'm just not getting enough sleep, so I'm going to start spending more time in bed.