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The Scientific and Monastic Practice of Sleep Restriction

April 23, 2014

According to Saint John Chrysostom, “animals recognize sufficiency as a limit with respect to food and water and will not go beyond what they need even if innumerable persons try to force them on to excess” (Saint John Chrysostom, Homily 58 on Matthew). He likewise remarks that “nothing is so conducive to enjoyment and health as to be hungry and thirsty when one sits down to eat, and to identify being full with the simple necessity for food, never overstepping the limits of this, nor imposing an overwhelming load on the body (Saint John Chrysostom, No one can harm the person who does not harm himself). Examples from nature and from daily life indicate that limits and restrictions can be good for our health. Could these examples offer us some help with the problem of insomnia?

In fact, they are not so far removed from the seemingly counter-intuitive suggestion offered by modern behaviorists: for better sleep, it is helpful to remain less time in bed trying to sleep, not more.  Now, we’ve all experienced nights when we could do nothing but toss and turn in bed, leaving us wearier from the unwanted exercise. While such experiences are unpleasant, for most of us they are infrequent. Unfortunately, the insomniac encounters such difficulties more often than not in trying to get a good night’s sleep. The response of scientific literature is: “stop fighting, give up, and get out of bed.” In other words, if you aren’t able to sleep within the first twenty minutes of retiring for bed, don’t continue to lie in bed, struggling to sleep.

Alfonso Marino describes this in terms of sleep restriction. He writes, “Sleep restriction limits the amount of time spent in bed to actual sleep time. Individuals with insomnia tend to spend excessive amounts of time in bed in an attempt to make up for a sleepless night. Sleep restriction incorporates a formula for calculating sleep efficiency. Sleep efficiency is calculated by dividing total sleep time by total time in bed and multiplying the ration by 100. The goal with sleep restriction is to increase an individual’s sleep efficiency to above 85%.”

Such a calculation may be a valuable tool in determining sleep efficiency and eliminating one of the inhibitors to better sleep: too much time spent in bed without sleep. This is analogous to a person who wants to lose weight and is told by a doctor to write down each and every food and drink item that is consumed during a given day is often surprised to find the quantity and quality of consumption. Each of us has a personal self-narrative to which we tend to adhere unless something or someone shatters that very often false self-conception.

Sleep restriction also serves to counter another factor in insomnia-frustration. When we’re unable to sleep and remain tossing and turning, our level of frustration grows which makes it more difficult to sleep. When you recognize and accept that sleep will be difficult on this particular night (without catastrophizing) and arise from bed, you are making a healthy choice.

In therapeutic settings, Marino notes that “at the 6 month follow-up point, approximately 66% of treatment groups members found sleep restriction somewhat helpful and 34% found it as very helpful. By the end of the study, no participants felt that sleep restriction was not helpful.” In the final analysis, sleep restriction seeks to curb behavior that is not beneficial (staying in bed without sleep) in order to maximize the benefit of fruitful behavior (actual time spent sleeping in bed). Because we can become creatures of habit, we need to take time to reflect upon our behavioral patterns and consider change.

vigillampAdmittedly, the fathers spoke far more about vigil and trying to stay awake than they did about insomnia and trying to fall asleep. They would deny themselves physical food and drink, sleep for the body, and other earthly pleasures for the sake of spiritual nourishment, rest for the soul and heavenly delight in Christ. Some, like Abba Arsenios, would spend the entire night in vigil and then when dawn came, call out to sleep and sleep would come (Gerontikon, PG 65.88C). Others, like Abbas Poimen, would point out that while they couldn’t do without food, clothing, and sleep, they could in part cut down on the amount needed (Gerontikon, PG 65.368). And they found that this restriction in sleep, in food, and in clothing brought a light into their heart through which they could more clearly see Christ. Sleep restriction has been practiced by monks for millennia. When they cannot sleep, they pray, they give glory to God, they repent, and they seek the face of Christ. They do not remain inactive in their beds, but use their time wisely, redeeming the time. And when they do finally retire for rest, sleep comes. And it is peaceful and sweet.

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