January 2005

Vol. 4, No. 1

Subscribe to this newsletter at www.drmcdougall.com

Printer Friendly Page

Sleep Like a Baby – Lessons from My Grandson on How to Cure Insomnia 

My 12-month old grandson, Jaysen, and I (Dr. John McDougall) suffer from insomnia.  You might guess this condition is inherited.  When we can’t sleep we are miserable and so are all those people around us.  Those times when his mother’s warm, comforting breasts fail to lull him to sleep, Jaysen becomes energized by his mother’s most perfect food – all fired up and ready to entertain his parents until the late evening hours.   Unfortunately, this is not always fun for mom and dad.  Parents long for a few peaceful hours after their children go to bed. 

In order to avoid these bouts of insomnia, Jaysen’s mother makes certain bedtime is always on time.  Jaysen arises early each morning, because if he sleeps in past 7 AM, then he stays up late that night.  If he naps too long during the day or too late in the day then he is not ready for bed by 7 PM – and his parents tire quickly from his “sleeplessness.” Thus, through trial and error his mother has independently discovered (like most parents) an already scientifically established cure for insomnia – a cure known as “sleep restriction.”

Sleep Restriction Therapy

At least 25% of adults suffer from insomnia.  Estimates are 18 million prescriptions are written every year for sleeping pills.  For many people a nightcap of alcohol is their sleeping pill.  Both drugs have serious drawback, including dependency. Yet, there is a simple, cost-free, safe solution.  “Sleep restriction” is time-honored therapy, reported first in 1987 in a respected medical journal to effectively and safely cure insomnia.1   The treatment is non-toxic, always effective, cost-free, and side-effect-free.  The only down-side might be daytime fatigue – especially if you over-restrict your sleep – but not when properly used.  So why do you not hear this recommendation from your doctor when you complain about insomnia?  Why are you given a sleeping pill as automatically as a reflex reaction to your complaint?  Why doesn’t this trusted advisor simply recommend, “Don’t sleep so much.”?  For the same reason other diseases (heart disease, diabetes, arthritis, depression, etc.) are treated with drugs rather than with obvious diet and lifestyle changes:  PROFIT. And there are other reasons: to the patient, drugs seem to require less effort – but in the long run they cost the patient much more – and they never cure chronic conditions.  Many people do not feel satisfied with a visit to the doctor if a prescription is not forthcoming.

Another Overindulgence: Sleep

Common knowledge says adults need 8 hours of sleep, and even more is better.  Sleep is seductive – during these hours you can escape from pains of daily life.  There are phrases such as, “beauty rest” and “no rest for the wicked” – which imply “good people” sleep more.  However, like almost everything else in life, an excess is harmful.

Infants and children need more sleep than 8 hours, and so do pregnant women. When we are sick we need extra rest to recover.  But normal healthy adults really need only 5 to 7 hours a night.  Oversleeping leads to troubles as irritating as insomnia and as serious as suicidal depression.3  Studies have shown that there is a “depressogenic” substance that is produced during sleep – this, as yet unidentified “substance,” is washed out during wakefulness.  Knowledge of benefits of sleep restriction has lead to the best treatment of mild to severe depression.4-10  Research shows that as many as 70% of seriously depressed people – some so depressed they are on the verge of suicide – can be completely relieved of that painful state with one night of “total sleep deprivation.”  Simply restricting hours of sleep is a highly effective, non-toxic, cost-free therapy for depression.  Even people without diagnosed depression improve their moods by not oversleeping.8

The Technique

If you have insomnia, then relief is as close as your alarm clock.  Think of the most recent “poor” night’s sleep you had.  How many hours did you actually sleep?  Pick this number for the amount of time you are going to spend in bed tonight.  For example, if you slept only 4 hours during your last bout with sleeplessness, then tonight you will spend only 4 hours in bed.1 If sleep is found to be sound (efficient) after tonight, then you can add 15 minutes to the time allowed in bed the next night. These additions can be made until you find the right number of hours in bed to cause you a restful night.  People suffering from troublesome night time frequent urination and restless leg syndrome at night may find relief with this technique.

In addition to reducing the time spent in bed, you need to have consistency with your times in bed – off to bed in the evening and rise in the morning at the same times.  Restriction of stimulating beverages, like coffee and tea, will be very important.  Most people find a “good night’s sleep” from about 6 hours each night in bed.2  

I have found 6 hours of sleep works for me – more than that and I won’t sleep well the next night, and significantly less than 6 hours for several nights will cause me to become fatigued.  Jaysen’s mother will tell you that control of Jaysen’s time in bed is essential for a happy family life.  You will need to exercise similar discipline if you are having difficulties caused by oversleeping – in order to cure your insomnia.

References:

1)  Spielman AJ, Saskin P, Thorpy MJ.. Treatment of chronic insomnia by restriction of time in bed.  Sleep. 1987 Feb;10(1):45-56.

2)  Morin CM, Kowatch RA, O'Shanick.  Sleep restriction for the inpatient treatment of insomnia.  Sleep. 1990 Apr;13(2):183-6.

3)  Giedke H, Klingberg S, Schwarzler F, Schweinsberg M.  Direct comparison of total sleep deprivation and late partial sleep deprivation in the treatment of major depression.  J Affect Disord. 2003 Sep;76(1-3):85-93.

4)  Wirz-Justice A.  Sleep deprivation in depression: what do we know, where do we go?
Biol Psychiatry. 1999 Aug 15;46(4):445-53.

5)  Giedke H.  Therapeutic use of sleep deprivation in depression.  Sleep Med Rev. 2002 Oct;6(5):361-77.

6)  Adrien J.  Neurobiological bases for the relation between sleep and depression.
Sleep Med Rev. 2002 Oct;6(5):341-51.

7)  Letemendia FJ.  Diagnostic applications of sleep deprivation.  Can J Psychiatry. 1986 Nov;31(8):731-6.

8)  Wu JC. The biological basis of an antidepressant response to sleep deprivation and relapse: review and hypothesis.  Am J Psychiatry. 1990 Jan;147(1):14-21.

9)  Wehr TA.  Improvement of depression and triggering of mania by sleep deprivation. JAMA. 1992 Jan 22-29;267(4):548-51.

10)  Leibenluft E. Is sleep deprivation useful in the treatment of depression?  Am J Psychiatry. 1992 Feb;149(2):159-68.

Email this page to a friend or coworker

   
  You may subscribe to this free McDougall Newsletter at http://www.drmcdougall.com
  Newsletter archive


2005 John McDougall All Rights Reserved