Good Hope, Heartlands, and Solihull Eye Clinics
- edited D Kinshuck, from Guardian/Hugh Selsick, Insomnia Clinic in Bloomsbury
- Everyone needs a different time asleep
- no tea/coffee before bed (caffeine is a stimulant, and reduce during the day)
- Sleep diary
- time they go to bed what time they get up
- how long it took to fall asleep
- how many times they wake during the night
- insomniacs will go to bed earlier or stay in bed longer in order to increase their sleep opportunity.
- no lie-ins
- no naps (chewing gum keeps napping at bay).
- If you think you need 6 hours sleep, and have to be up at 7am, go to bed at 1am, to compress sleep time
- Then go to bed earlier 15 minutes each time..will be exhausted initially but this helps
- Leave bedroom after 15 minutes awake, only sleep/sex in bedroom
- CBT should be your first port of call prior to medication.
- treatment Hugh Selsick, a South African psychiatrist, the Insomnia Clinic in Bloomsbury
- " CBT should be your first port of call prior to medication. "
“The first thing I do [on the programme],” Selsick told me, “is dispel the myth that there’s a certain number of hours you are supposed to get. It is ingrained in us as if it’s absolute gospel that you are supposed to sleep eight hours a night. It’s not true.” Just like there is variation in shoe size, Selsick says, there is variation in the amount of sleep an individual requires. “Some people need six and a half, some people need nine and a half. It doesn’t make anyone abnormal.
- To figure out how much sleep they need, each attendee is told to start a sleep diary, recording what time they go to bed, what time they get up, how long it took to fall asleep and how many times they wake during the night. Next Selsick undoes the idea that a person should have a set bedtime. Typically, insomniacs will go to bed earlier or stay in bed longer in order to increase their sleep opportunity. The logic appears sound – if I’m not getting enough sleep, I should spend longer in bed to give myself more opportunity to sleep – but the anxiety invariably exacerbates the problem. Instead, patients are told to set a hard-and-fast time to wake up. “We tell them to always get up at the same time every day, regardless of how much they’ve slept, what time they’ve gone to bed, or what they’ve got to do that day.”
- There must never be any lie-ins, and never any naps (chewing gum, Selsick says, keeps napping at bay). The theory is that if you get up at the same time every morning, you begin to feel sleepy at the same time every night, and, over the weeks, your bedtime will naturally become consistent. “We compress their time in bed down so that their sleep is more compact and tighter,” explained Selsick. A patient might start with a goal of six hours’ sleep. If they need to be up for work at 7am, this means they are forbidden from entering the bedroom till 1am. “That’s now your earliest permitted bedtime.”
- Once a patient finds they are asleep for 90% of the time that they are in bed, they move that earliest bedtime forward by 15 minutes at a time. This behavioural technique is termed sleep efficiency, and despite its disarming simplicity, patients report astonishing results. “It was very hard going,” said Laurell Turner, a medical student who completed the programme in 2016. “By the end of the course I was exhausted. But despite my scepticism, the results were immediate.”
- Selsick worked to break the negative associations Handler had with her bedroom. When insomniacs go to bed they often feel afraid of having to lie there frustrated and increasingly irritated. After a while the simple act of going to bed begins to wake an insomniac up. The bedroom becomes a trigger toward alertness, even fear. To counter this, Selsick urges patients to leave the bedroom after just 15 minutes if they are not yet asleep. All activity apart from sex and sleep is barred from the bedroom. Patients are even told to change their clothes in another room. ""