Want to sleep MORE? Spend LESS time in bed!

You’re tired. It looks so tempting. But . . .

ALL THIS week in the Mail’s life-changing series, Professor Jason Ellis has drawn on his experience to help tackle your sleep problems. Today, in the final part of his series, he reveals a specialist technique called sleep rescheduling that will help end your sleep problems for ever . . .

WHen you have had insomnia for years, it’s very common to find yourself inadvertently stretching out your night by going to bed super-early when you get the chance and giving yourself long lie-ins as you desperately try to catch up on lost sleep.

But this is the worst thing you can do. If you have been following my plan all week, and dutifully filling in your sleep diary — morning and night — then you will, by now, have a clear picture of your own insomnia. You may also have noticed things starting to improve as you work your way through all the different techniques and exercises.

But there is one unspoken problem we have yet to cover. For, if your life has been blighted by insomnia for years, it’s likely you’re spending too long in bed.

It’s a perfectly natural response to sleeplessness, and one I see every day in my practice. But it’s seriously damaging to the power of your sleep.

This is because extending the time you spend in bed makes sleep more shallow and, therefore, less potent in terms of providing adequate mental and physical rest. And the shallower the sleep, the more vulnerable you are to being woken up.

If you spend too long in bed every night of the week, your body and brain become accustomed to this pattern of light sleep punctuated by frequent wakefulness.

You end up ‘sleep surfing’, where you lie in bed, dipping in and out of fitful, restless sleep.

So you nap when you can, switch the alarm to snooze mode and skip nights out to go to bed everearlier in your attempts to catch up on lost sleep.

The key to putting an end to this destructive pattern is simple. You need to shorten the amount of time you spend in bed. It may sound counter-intuitive, but trust me on this. The idea behind so- called sleep rescheduling is that, by consolidating your sleep, you effectively concentrate and condense it to ‘thicken’ it and toughen up the vulnerability points.

It makes the dips in the night that render you vulnerable to being woken by bad dreams, distant noises or nagging worries far fewer in number, and your sleep more intense and refreshing.

It’s not easy — which is one reason why I’ve left it to last. (And if you’ve been following my plan and have already dramatically improved your sleep, then you don’t need to try it.)

The aim is to achieve perfect sleep — the sort of sleep duration and quality that you might have enjoyed before insomnia blighted your life. I can’t tell you whether that will be six hours a night or eight. It’s a very personal issue, but I can help you find your perfect sleep duration, thanks to the personalised element of this plan.

AnD that’s where the power of your sleep diary comes into its own. That’s another reason why we’ve left this very important step to the end. In order to truly personalise this part of the plan, I need you to have completed a week’s worth of diary entries. Do see your GP before embarking on sleep rescheduling if you have any health concerns or illnesses, and be aware, this sleep tool is not appropriate for people with bipolar disorder, psychosis or epilepsy, or if you have a history of seizures, post-traumatic stress disorder, migraine or head injury.

I need to warn you now that this is going to involve going to bed later than you probably have done for years and, that because insomnia is conditioned, you might initially wake up during the night.

This means you are likely to be even more tired during the day than normal — but just for a few days. I can assure you any discomfort will be short-lived, and your life could change irreversibly for the better.

Think of it a bit like sleep training a baby — a few nights of discomfort and a few super-bleary days, but a potential lifetime of blissfully silent nights.

This isn’t actually restricting your sleep, it is merely restricting the time you spend in bed. And there are very good scientific reasons why this is a good idea.

Still not convinced? Ask yourself how long you’ve had insomnia. If you’ve been struggling with sleep for roughly three nights a week over the past two years, you’ll

have had 312 nights blighted by insomnia. Are you willing to trade a few nights of re-ordered sleep now for 312 nights of insomnia in the future?

With this in mind, it is a good idea to start this when you have a couple of days without commitments, or at the weekend — tonight! — so you have a couple of days without having to be properly focused for work.

Start now and you can spend the weekend adjusting, but be one big step on the road to recovery by Monday.

(Be aware that this is not a decision to take lightly, and you should take special care if you need to drive anywhere or operate machinery. If you do, take a moment to work out whether this is realistically manageable for the next seven days, and perhaps delay until you can take a few days off work to focus properly on your insomnia.)

CALCULATE YOUR NEW, LATER BEDTIME

1 Work out how much sleep you actually get each night.

At the bottom of your morning diary entry, we have asked you to calculate your ‘total sleep time’ for the night (the total time you spent in bed, minus the total time you spent awake).

Use a calculator and add together all the ‘total sleep time’ calculations you have, then divide this figure by the number of days you’ve kept your diary.

Ideally, this should be at least seven continuous days. The result will give you an average total sleep time in minutes.

This figure shows exactly how much time you are spending asleep each night. If your insomnia is bad, you might be shocked to see how little sleep you are getting. All the more reason for you to be doing this!

If your average total sleep time works out at less than five hours (300 minutes), it’s a sign that you really are having a tough time. No matter how low your average total sleep time is, never try sleep rescheduling on less than five hours (300 minutes) per night.

2 SET a firm, unchange - able morning wake- up time. Think long-term: this will be the time you set your alarm and the time you get up for the foreseeable future — weekends and holidays included — because this is the best way to anchor the circadian rhythm, which controls when you wake and when you sleep.

Most people set this as the time when they need to get up and get ready for work, or get the children ready for school.

even if you don’t work or you’re retired and have no morning commitments, it’s important to set a non-negotiable wake-up time that works best for you.

3 Work out your temporary new bedtime. To do this, take your total sleep time (the average of all your calculated sleep times) and count backwards in minutes from your new, set wakeup time.

So, if you decide that, from now on, your morning alarm will go off at 7am and your sleep diary reveals you average six hours’ sleep per night (360 minutes), your new bedtime — for the period of this sleep rescheduling exercise — should be 1am.

Do not, under any circumstances, factor less than five hours in bed.

The sleep diary and your preferred wake- up time mean this is a completely individual calculation, but you are very likely to find that your new bedtime is a lot later than you imagined. Trust me here and stick with this.

Any compromise now will significantly dilute the impact of this very powerful technique.

4 STICK to your new schedule, going to bed at your temporary new bedtime and getting up when your alarm goes off — with no deviation — for seven nights, and keep religiously filling in your sleep diary while you do so. I urge you not to buckle or even think about adjusting your new bedtime. Bringing it forward even by a few minutes will produce a watered-down effect. remember, you’ve done the calculations and you know how much total sleep you get each night. even if your new bedtime seems horribly late, you will still be getting exactly the same amount of sleep as you were before. However, it may take a few days for your body and brain to adjust to your new concentrated sleep regimen. In the first few days, if you still struggle to fall asleep, or you wake up in the night, you’ll find you have to function on a little less sleep even than normal. keep yourself and others safe, and keep the faith. This is only short-lived. Studies have repeatedly shown that this method really does work. Very swiftly, your body and brain will be forced to accept that bed means sleep the minute your head hits the pillow. Just as important, your sleep will be deep and refreshing.

Would you prefer six hours of really good quality sleep or eight hours of really poor quality sleep?

5 No napping, no compensating, no catching up at weekends. The only exception to this rule is if you feel so sleepy during the day that you absolutely need (as opposed to want) to sleep. This could be a sign of other health issues and you must see your GP before continuing.

However, most people report that, at first, sleep rescheduling has very little impact on their overall levels of tiredness, since they’re getting exactly the same amount of sleep as they always did.

Indeed, you should very soon start to feel better — fresher, more alive and optimistic — than you have for a very long time, because your sleep will be consistent, deep and good for the first time in years.

every night you get it right — falling asleep within minutes of going to bed, sleeping through the night and not waking up ahead of your alarm — you will be sending positive reinforcement messages to all the subconscious mechanisms that have been keeping you awake at night for so long without you realising.

IMPROVE YOUR SLEEP EFFICIENCY

THE most important aim of sleep rescheduling is to boost the quality of your sleep, and we’ve had to shorten your time in bed in order to get there. But once the penny has well and truly dropped in terms of the mechanisms by which your body and brain fall and stay asleep, it’s safe to start extending your time in bed, bringing your bedtime gradually forwards.

In most cases, it takes at least seven days of strict sleep rescheduling to do the trick. So keep checking the ‘sleep efficiency’ score in your sleep diary. This is the measure of how much time you actually spend asleep compared with how much potentially wasted time you find yourself spending in bed.

You may need a calculator to work it out. Take your total sleep time and divide it by the total amount of time you spent in bed (the number of minutes between the moment you got into bed at night and when you got out of bed in the morning).

Then multiply this figure by 100 to get a percentage score.

Many people with insomnia find their score is around 60-70 per cent, which indicates they are spending 60-70 per cent of their night asleep in bed. That’s super-inefficient.

Your aim, by working through my plan all this week, has been to nudge your score up to get it closer to an 85 per cent ideal.

If your sleep efficiency score after a week of sleep rescheduling is at 8590 per cent, keep your bed and wake time constant for another week.

This has to be a slow process in order to maintain sleep consistency, and to avoid tipping the balance in the wrong direction and inadvertently allowing yourself too much time in bed again.

If your score is still below 85 per cent after the first week, you should consider taking 15 minutes off your total sleep time and going to bed 15 minutes later than before, in order to condense your sleep time even further and encourage the concentrated sleep that defies nighttime wakening. But remember not to go below five hours.

only move things by 15 minutes per week, keep to your set wake time and continue your sleep diary every day. remember, your wake-up time is anchored and should not change unless absolutely necessary.

If you sleep solidly and consistently for the next seven nights, then you are ready to start pushing your bed-

On average, we set our alarms for 6.47 every morning, but don’t get out of bed until 7.12am

time forwards again. Bring your bedtime forwards by 15 minutes — one 15-minute adjustment every week.

Eventually, you will hit upon your new cut-off point — the set bedtime you can stick to longterm, which will pretty much guarantee a great night’s sleep every time.

You know you’ve reached the finish line when you have a sleep efficiency score of 85-90 per cent and consistently feel refreshed in the daytime.

This process cannot be rushed, or you risk wiping out all your hard work in the first week of sleep rescheduling.

If, at any point, your average sleep efficiency over seven nights starts to dip, or busts the 90 per cent optimum, you could have gone too far.

A score higher than 90 per cent indicates very little time awake, which could hint at sleep deprivation. (If you’re a parent, you’ll know that a child is sleep deprived if they fall asleep within seconds of their head hitting the pillow, or even while brushing their teeth! It’s the same principle.)

If this happens, just add 15 minutes to your sleep time to see if your sleep efficiency re-settles. Bear in mind that the over-60s or those with illness or who are on regular medication might need to settle for closer to 80-85 per cent to account for the fact that age and medication can cause you to naturally spend short periods of the night awake.

Even good sleepers, let alone ‘normal’ sleepers, still take a little time to fall asleep at night — some nights more than others.

And many people who’ve never experienced insomnia may, on occasion, spend a small amount of time awake during the night.

As you play with restricting your time in bed, it’s very important to keep a constant eye on the fivehour minimum rule.

Less than five hours sleep per night is not good for your health, so no matter what your sleep efficiency score, you should never have less than five hours in bed.

SLEEP WELL IN THE LONG-TERM

CONGRATULATIONS! You’ve come to the end of my sleep plan and you should now be on the road to enjoying great restorative sleep. But if insomnia has been your norm for many years, you’re likely to be a little nervous that it might return. Please don’t treat your sleep as fragile and worry that, if you stop working with my techniques, your insomnia will come back. That rarely happens.

The more you worry about wrapping yourself up in cotton wool, the more likely you’ll for ever be anxious about sleep — never a good recipe for sleeping well.

You can work to protect your new- found sleep security by teaching yourself a bit of what we call positive reinforcement.

In your insomnia days, you might have involuntarily linked certain behaviours with poor sleep. simply brushing your teeth, for instance, might have triggered stress as your body anticipated the sleepless night ahead.

But now you have control of your insomnia, you can use the same unconscious mechanisms to work in your favour by associating certain habits with good sleep and, thereby, reinforcing your chances of good sleep when you repeat them.

When you’ve been sleeping well for a number of weeks, try introducing something new into your sleep routine — such as a certain book, or the application of a delicious aromatherapy oil to your pillow.

Each great night of sleep then becomes unconsciously ‘paired’ with that trigger, action or smell.

repeating the pairing will, over time, ‘condition’ that response, strengthening the association between the two.

Eventually, with enough pairings, the stimulus will automatically generate the conditioned response. so, if you find yourself having a poor night of sleep, you can pick up that special book, or use a drop of that essential oil, and may find it induces sleepiness.

As you move forward into a life without insomnia, it’s a good idea to be alert for risks and apply a little early management to ensure any new sleep disturbance passes as quickly as it came, without ever having the chance to develop into acute or chronic insomnia.

Jet lag is a classic example. If you are travelling long-distance across time zones, the key is to alter your schedule a day or two before you travel by aligning light, food and exercise to your destination time. If you are travelling to the u.s., for example, start nudging mealtimes and exercise times closer to u.s. time.

At other times, if you find a newly stressful event in your life starts to keep you awake at night, it is important that you do nothing.

no naps, no lie-ins, no switching to the spare bedroom. Have faith that this will pass. Insomnia can only properly take hold when we start thinking and acting in different ways to try to compensate for our lack of sleep.

You can protect your sleep long into the future by following these rules: 1 Always stick to a set bedtime THE odd late-night or lie-in won’t open the insomnia floodgates, but stick to a small (30-60 minute) deviation from your set bedtime and your alarm call, and don’t deviate for more than two days in any week. Even if you have a bad night, do not attempt to compensate with a nap or a lie-in.

Also keep your wake-up time the same — every day, irrespective of how much sleep you got the night before.

If tiredness makes a small nap unavoidable in the daytime, or you find yourself extending your time in bed (at either end), make sure you pay that time back. so if you go to bed an hour earlier than normal, push your bedtime back by an hour the following night. 2 Clean up your sleep hygiene good sleep hygiene is important whether you’re a good, normal or poor sleeper, so stay with the darkened bedroom, the quiet evening wind- downs, not too much caffeine or alcohol, and keep the pets off the bed. 3 Keep the bed for sleeping sTICk to no computers, TV, eating or phones in bed. Just sleep and sex — and no napping during the day. 4 Time to bring back books onCE things have settled, and your sleep efficiency is stable and good, you can start to incorporate some of the fun things you enjoyed back into your bedroom — such as books. But never electronics, work, food, exercise or pets.

We Would like to know the impact of the daily Mail’s serialisation on your sleep. Please send us copies of your completed sleep diary. We want the information to be confidential, so leave out any identifying information, such as your name or address — just include your age and sex. Send to: Professor Jason ellis, Northumbria Sleep Research laboratory, Faculty of Health and life Sciences, Northumbria university, Newcastle Ne1 8ST.