Sleep Restriction

Sleep Restriction is behavioral intervention used in the treatment of insomnia. It is an evidence based treatment for insomnia, both as a standalone technique and as part of a package of cognitive behavioral therapy for insomnia (CBT-I). The rationale for sleep restriction is that insomnia is perpetuated by spending excessive time in bed. Spending large amounts of time in bed relative to little sleep results in poor sleep efficiency. One goal of sleep restriction is to increase sleep efficiency by reducing the amount of time spent in bed relative to the time spent sleeping. Sleep restriction initially creates a mild sleep deprivation which promotes the natural onset of sleep.

The Sleep Restriction handout includes a description of the sleep restriction intervention followed by instructions for carrying out sleep restriction.

1. Clients are instructed to keep a sleep diary for a week. This allows calculation of baseline measures.
2. Clients are instructed to calculate their average total sleep time (ATST). This is the average number of hours slept per night.
3. Clients are then instructed to restrict the time they spend in bed to no more than their average total sleep time. This involves deciding what time to get up in the morning then subtracting ‘ATST’ hours from that time – this is the new ‘going to bed’ time.
4. Clients are instructed to monitor their sleep efficiency by continuing to keep a sleep diary.
5. Rules are given for increasing total amount of sleep.

• Miller, C. B., Espie, C. A., Epstein, D. R., Friedman, L., Morin, C. M., Pigeon, W. R., ... & Kyle, S. D. (2014). The evidence base of sleep restriction therapy for treating insomnia disorder. Sleep Medicine Reviews, 18(5), 415-424.
• Spielman, A. J., Saskin, P., & Thorpy, M. J. (1987). Treatment of chronic insomnia by restriction of time in bed. Sleep, 10(1), 45-56.
• Spielman, A. J., Yang, C. M., & Glovinsky, P. B. (2011). Sleep restriction therapy. In Behavioral Treatments for Sleep Disorders (pp. 9-19).
• Wohlgemuth, W. K., & Edinger, J. D. (2000). Sleep restriction therapy. In K. L Lichstein & C. M Morin (Eds.), Treatment of late-life insomnia (pp. 147-166). Thousand Oaks, CA, US: Sage Publications, Inc.