Dr. Peter Attia

I think the time in bed restriction is pretty interesting. And in talking with sleep physicians who also implement this, it seems quite draconian at the outset. It can be remarkably difficult. They're giving people five hours in bed max, and they're really trying to force sleep pressure. How do you navigate that? And how do you decide how hard to squeeze the tube of toothpaste?

I think the time in bed restriction is pretty interesting. And in talking with sleep physicians who also implement this, it seems quite draconian at the outset. It can be remarkably difficult. They're giving people five hours in bed max, and they're really trying to force sleep pressure. How do you navigate that? And how do you decide how hard to squeeze the tube of toothpaste?

It's like a food frequency questionnaire in epidemiology. Totally. Total waste of time. Total.

It's like a food frequency questionnaire in epidemiology. Totally. Total waste of time. Total.

Six hours being the number?

Six hours being the number?

And just to be clear, let's say five and a half is the floor. Six is typically what you would do. So six and a half in bed.

And just to be clear, let's say five and a half is the floor. Six is typically what you would do. So six and a half in bed.

I see. So when I bring my sleep log to you, you've seen that for the past week, I've been spending 12 hours in bed. But by my recollection, because I'm looking at the clock when I'm not sleeping, I'm only getting six and a half hours of sleep in the 10 or 12 hours I'm laying there. You're going to say, oh, okay, that's your sleep time. Take that, add 30, that's your time in bed. I got it.

I see. So when I bring my sleep log to you, you've seen that for the past week, I've been spending 12 hours in bed. But by my recollection, because I'm looking at the clock when I'm not sleeping, I'm only getting six and a half hours of sleep in the 10 or 12 hours I'm laying there. You're going to say, oh, okay, that's your sleep time. Take that, add 30, that's your time in bed. I got it.

Yes, yes.

Yes, yes.

They're going to bed at one in the morning.

They're going to bed at one in the morning.

Now, let's say you're doing the sleep log and they're spending eight hours in bed, getting four hours of sleep. Let's say they're getting five hours of sleep, eight hours in bed, and then they're taking an hour nap a day. So they're removing all their sleep pressure during the day by taking that nap, but they kind of need to take the nap because they're not getting enough sleep.

Now, let's say you're doing the sleep log and they're spending eight hours in bed, getting four hours of sleep. Let's say they're getting five hours of sleep, eight hours in bed, and then they're taking an hour nap a day. So they're removing all their sleep pressure during the day by taking that nap, but they kind of need to take the nap because they're not getting enough sleep.

So they're in this vicious cycle. So do you add the hour of nap time back to sleep and say, actually, you're getting six hours of sleep. Let's do the exercise based on five plus one plus a half, 6.5.

So they're in this vicious cycle. So do you add the hour of nap time back to sleep and say, actually, you're getting six hours of sleep. Let's do the exercise based on five plus one plus a half, 6.5.

Okay, but just to be clear, if you have someone who is using a nap to compensate for their insomnia, step one is just kill the nap. Kill the nap. And then let the cards settle where they may for a week, recalculate actual sleep time, and then go through the exercises described. I've made this point on a podcast before, I think, but just want to get your blessing.

Okay, but just to be clear, if you have someone who is using a nap to compensate for their insomnia, step one is just kill the nap. Kill the nap. And then let the cards settle where they may for a week, recalculate actual sleep time, and then go through the exercises described. I've made this point on a podcast before, I think, but just want to get your blessing.