Increasingly, I am meeting with more and more clients who have access to sleep technology.

When I first started learning about insomnia treatment, the recommendation was not to trust sleep technology data. I have since adjusted my view a bit because technology has evolved, but I still like to remind people that the majority of sleep technology is based upon movement; this is diffferent than actual sleep. True sleep is measured in brain waves. You can be very still and relaxed, but not asleep, and technology often doesn't register the difference; likewise, you can be moving but still be getting sleep. Additionally, I find that a lot of the data isn't necessarily bad, but it is often given without context.

This last point is one that makes a big difference.

In a culture where we tend to think "more is better," I find that sleep technology is often hinting that "more is better." This is definitely not the case in sleep. In fact, always defaulting to go for "more" by increasing your time in bed is actually one of the causes of insomnia.

What do I recommend?

I recommend knowing how much sleep your body has gotten in the last two weeks and then aiming to get that amount of sleep every night for 2 weeks straight, keeping a consistent bedtime and alarm time in the morning.

Then, you can adjust your amount of sleep after 2 weeks. If you are feeling well-rested and sleeping easily, you may not be in need of "more." If you sleep through to your alarm every day and don't feel like you have enough energy during the day, then you may benefit from more, but try increasing it in small increments, like 15-minute increments.

And of course, if you're saying, "I can't control my sleep and who knows how much I'll get from one night to the next!"...you may want to consider that you are experiencing signs of insomnia, and in which case, the use of CBT-I techniques can help.

​Happy Sleeping,

Alissa S. Yamasaki, Ph.D.

I've had the book, "Zen and the Art of Motorcycle Maintenance: An Inquiry into Values" by Robert M. Pirsig (1974) on my bookshelf for a long time. I finally have gotten started and am enjoying it. It's a book that you can read a little at a time, and it's definitely not a read to hurry through. He has a great quote:

“When you want to hurry something, that means you no longer care about it and want to get on to other things.”

I think this applies to the sleep process in a lot of ways.

CBT-I (cognitive-behavioral therapy for insomnia) is a stand-out therapy in terms of how quickly change can be made, as it typically runs for 6-8 sessions. This is quite atypical for just about any other psychotherapy treatment for any problem; the only other treatment that is shorter that I can think of off of the top of my head is for simple phobias, like a snake phobia (did you know snake phobia was part of my research as a grad student?).

The quick nature of turning around sleep patterns does not mean that we are hurrying sleep. What is your relationship to sleep?

I've been talking a lot about sleepiness in these emails, and I'm going to squeeze it in again today because it's important and relevant to the idea of not hurrying: you cannot hurry the process of becoming sleepy; while sleep medications have their place, they also give us the impression that we should be able to "turn on" sleepiness at will. Our bodies just don't naturally work that way.

If you struggle to fall asleep or return to sleep, it's important to allow your body to experience non-medication-induced sleepiness.

Listen for the sleepiness and pay attention to when that process actually happens. Then, consider if the time that you are shutting off your lights and trying to fall sleep is timed to that naturally-occurring sleepiness.

If your natural sleepiness and bedtime aren't timed together, then you have a big, easy opportunity to make change -- turn out your lights at the time your body is naturally sleepy and NOT before then, even if that time is much later than you wish to sleep. The second, separate step, is to move your bedtime earlier gradually...but ONLY AFTER you have established your body's sleepy time and fallen asleep at that time regularly. The second step is less of an insomnia issue and more of a circadian rhythm timing issue (often related to social jet lag).

If you are saying to yourself, "But if I wait for sleepiness, it will never come!" Well, then it is likely that what you are dealing with is a clinical level of insomnia. Insomnia comes in many forms, and difficulty with feeling sleepiness when in bed is one of the common signs. It's one of the main symptoms that CBT-I techniques target, so that you can fall asleep, stay asleep and return to sleep using your body's natural processes.

As always, you can let us know if you wish to address insomnia. If you wish to get over the hump with sleep problems before the end of the year, now is the time to reach out. In case you missed it in my newsletter announcements, last I heard, we 1 or 2 immediate Wednesday slots open with Dr. Szczesny for one-on-one CBT-I sessions. Read her bio and schedule.

And, if you are considering taking the online program in January 2023, please respond to this quick poll about preferred times. I'm considering options for our next cohort.

Last week, I was talking about the impact of those little dozes that can accidentally happen in the evening, such as while watching television before bed. I also said that I would talk about what I do if I happen to doze in the evening.

First, I would like to say that napping has its place when done well. In contrast, dozing in the evening, intentional or not, is not a great habit for most people. This is especially true for anyone who is dissatisfied with their sleep.

Second, I would like to say, dozing is a sign of sleepiness, and it's a good habit to have gratitude for sleepiness. So often we can resent the feeling because we are trying to do something else at that moment. Sleepiness is a sign of the body telling us that it has done its preparation to be ready to sleep.

If I happened to doze, such as the scenario I mentioned last week on the couch while watching television, this is my decision-making process:

1) If it's really early in the evening (say, 7pm), then I definitely get up and get moving to do some type of awake activity, rather than relaxing quietly, as I know that relaxing quietly might lead to more accidental dozing. I might do some tidying-up, a load of laundry, etc. I'm usually not doing work-related tasks or thinking about things that are more emotionally-charged, but I make it a point to stay awake and alert. Later, I will do my usual nighttime routine to wind down at my usual time.

2) If it's late in the evening and closer to bedtime when I accidentally doze (say, 10 pm), I also generally will not attempt to go to sleep immediately. This is especially true if I notice that I'm starting to think about work or to-do items. Rather, I will actually stay up a little later than usual and wait until some sleepiness sets in (remember make sure that you know the difference between fatigue and sleepiness). Later, I shift into my usual bedtime routine, or maybe even a shortened version of my usual bedtime routine. I know that I will have a shorter night of sleep because I am staying up a little later, but the trade-off is worth it: I'm less likely to have trouble falling asleep or have restless sleep, and I am unlikely to particularly miss having a shorter night of sleep for just a single night of less sleep. I make a conscious choice to value quality over quantity.

3) If I'm honest, I also have a 3rd option. If it's late in the evening and close to bedtime when I accidentally doze (like above), but I just really want to get into bed, then I will just get ready for bed and go to sleep. Much of the time, because I routinely sleep well, this isn't a big problem (if you aren't routinely sleeping well and are often spending a lot of time awake, then you are highly likely to struggle to fall asleep in this scenario; I generally don't recommend getting into bed at this time). Generally speaking, I expect my quality of sleep to be a little lower, potentially more restless or more awakenings than usual because the dozing is so close to bedtime. However, because I understand how sleep mechanisms work, this doesn't worry me and doesn't particularly frustrate me, as I know how to recover in the following nights without difficulty.

Although #3 doesn't apply particularly well when you have long-standing difficulties falling asleep or other sleep problems, I share it because it highlights what smart, informed sleep choices look like when a person is sleeping well overall and has predictable sleep, but accidentally doze at a time that is not ideal.

Even if you have chronic sleep problems now, you can learn this type of sleep decision-making tailored to your individual sleep needs. It tends to be an empowering experience to grasp how sleep works. If you missed a previous post on CBT-I stats and are interested in seeing that example of how we make informed decisions about sleep, I made it into a PDF cbti stats for restedness.pdf, as it is easier to grasp in that version.

If you wish to receive blog entries directly to your inbox, I send them out weekly! Just sign up in the footer below. You can also read more about our services.

Happy Sleeping!

Alissa S. Yamasaki, Ph.D.

Licensed Psychologist, Sleep instructor

The topic of dozing has come up a few times this week in conversations with people working on sleep improvement, so I thought that this might be a topic worth covering here. I am wondering if this sounds familiar to any of you who struggle with sleep:

"I could barely keep my eyes open last night. I was sitting on the couch and watching t.v., and I think that I even fell asleep for a moment...I'm not sure how long it was. But, by the time that I got into bed, I was suddenly awake and it took me a while to finally go to sleep. It's so frustrating."

I can attest to this happening. I do it myself more often than I would like, and it's not a good habit because it sets up problems with sleep for the night. I'll write more next week on what I do in this situation if I happen to doze before bed.

At any rate, even if you just very briefly close your eyes in that scenario of sitting on the couch at night, the chances are, if we had an electroencephalogram (EEG) on your head to measure the actual brain waves, then in those brief moments prior to and while your eyes are actually closed, the EEG would show that you are getting actual sleep.

Sometimes, especially for people who have trouble sleeping, those brief dozes are enough to give you a "second wind" of energy for the evening and/or inhibit your ability to fall asleep quickly when you get in bed.

Interestingly, there is a sleep condition in which people have difficulty differentiating between being awake and asleep (paradoxical insomnia); many people who struggle with sleep probably are familiar with a little bit of this phenomenon, being unsure of when they are awake or sleep, finding sleep to be restless or fitful.

If you have trouble sleeping, I recommend minimizing allowing oneself to be in the state in which you are unsure if you are awake or asleep. I have previously recommended always differentiating between being sleepy and fatigued, and the importance of being intentionally awake (either relaxed or not) vs. intentionally asleep is equally important.

Being relaxed, with eyes closed, is not a replacement for good sleep. Many people who struggle with sleep do a lot of being relaxed, with eyes closed; this is not an appropriate strategy for dealing with lack of sleep; it serves to exacerbate the problem because little dozes can interfere with the ability to fall asleep and with the ability to have high quality of sleep at night.

If you're looking for a small behavior change to improve your odds for good sleep, then you want to catch those little dozes and get rid of them. Save up the pressure to sleep, also known as "sleep drive," for when you put your head on your pillow at bedtime. That will set you up for a better quality of sleep at night.

​You can read more about our services.

Happy Sleeping,

Alissa S. Yamasaki

Licensed Psychologist

A few weeks ago, I had the pleasure of working with Centre Volunteers in Medicine to discuss sleep with their behavioral health team. We discussed various interventions to help people who struggle with sleep, and one topic that came up is differentiating sleepiness vs. fatigue.

Have you ever wondered why you can feel EXHAUSTED but not fall asleep?

It's typical for people who have chronic sleep problems to experience a paradox of having extreme fatigue, but when given an opportunity to nap or sleep, they find that they cannot.

With chronic sleep problems, the body is on a type of overdrive which interferes with natural sleepiness.

How does one find sleepiness, and why is it so important?

Sleepiness is found when we have been awake for a sufficient amount of time. This amount of time varies by individual and circumstances. The higher a person's anxiety, the bigger the variations in when one wakes up in the morning, the longer you stayed awake in the morning lying in bed...all of those are factors (among others) dictate when sleepiness will arrive.

If you attempt to sleep before the "sufficient" amount of time has passed for your body's sleepiness kicks in and don't understand when to attempt to sleep (e.g., attempting too early in the night or staying in bed in the morning), then you will not find enough sleepiness to sleep well on a predictable basis.

Bottom line on this topic today? Start to differentiate between sleepiness and fatigue. Good sleep becomes predictable when there is sleepiness and not when there is only fatigue.

You can educate yourself and refine your sleep approach.

If you missed it in my last email, you can take a look at stats and how we use them to discern appropriate decisions to improve sleep when taking a formal, structured approach. You can also download a copy of a checklist of common reasons for fatigue if you are concerned that there might be reasons besides sleep that are driving your fatigue.

​You can read more about our services.

Happy Sleeping,

​Alissa S. Yamasaki, Ph.D.

Licensed Psychologist

P.S. - If you wish to receive this info directly to your inbox instead of finding it here, scroll down and complete the newsletter signup by checking the “sleep services” option. I write on sleep once on most weeks and announce service openings as we get them.

You may have heard me say that there is no "one size fits all" answer to a person's sleep problems and that finding good sleep is like finding a good shoe.

You want to try on the shoe and test things out, rather just wear the shoe model and size that your friend uses.

With that said, we use data to inform our sleep decisions and if the "fit" is a good one. I thought you might want to see an example of one of the nuances we sometimes face when we making decisions about sleep change.

The goal of sleep work is to 1) reset the body's sleep pattern, and then 2) progressively modify the sleep schedule to ultimately land on a personalized sleep formula that creates a feeling of confidence in the body's ability to sleep and a feeling of restedness.

In the process of narrowing down the formula for ourselves, we need to make the smart decisions.

Here's a typical example of how similar scenarios actually require different decisions. It's a topic we were discussing at the last Sleep Q&A with the current cohort, and this type of decision-making also comes up frequently in one-on-one CBT-I sessions.

Person #1: Doing sleep improvement because they don't feel rested

Sleep efficiency: 85% (amount of time spent in bed compared to amount of time spent sleeping; the higher the efficiency, the better, with above 85% being associated with decent sleep and "good" sleepers often at 90%)

Total time spent asleep: 7.0 hrs on average

Average number of nighttime awakenings: A lot. Sometimes too many to count.

Restedness: Low

A smart decision entails: Decrease the time spent in bed by 15 minutes. This will help reduce the number of awakenings, ultimately leading to feeling more rested even if the total number of hours of sleep is not yet long enough to be fully satisfying. Practice accepting that restedness will be low temporarily at this stage, but the priority is to minimize awakenings so that the body is better trained to sleep solidly and restfully before introducing longer times in bed. Do NOT increase time spent in bed for sleep yet.

Person #2: Doing sleep improvement because they don't feel rested

Sleep efficiency: 85% (amount of time spent in bed compared to amount of time spent sleeping)

Total time spent asleep 7.0 hrs on average

Average number of nighttime awakenings: 1 brief awakening to go to the bathroom and able to fall back asleep quickly

Restedness: Low

A smart decision entails: Increase time spent in bed by 15 minutes to increase the level of restedness. The body seems to be trained well enough to sleep solidly without interruption. If sleep efficiency continues to stay high after a couple of weeks, then again increase the time spent in bed by 15 minutes. The main task now is to slowly increase the opportunity given to the body to sleep in bed, while identifying the length of time spent in bed at which sleep efficiency starts to decrease (it will inevitably decrease at a point that is fit to your body's needs, and for some people it's closer to 6 hours or even lower, and for some people it's closer to 9 hours, and for many of us, it is in-between those two points).

~

Notice how the sleep complaint (not rested) and sleep stats were very similar, but the awakenings were different. This led to different sleep decisions.

We resisted the desire to just stay in bed in hopes of sleep getting better on its own (for Person #1), and we certainly did NOT use a one-size-fits-all approach or recommend trying to sleep for random lengths of time!

While it's too much information to go into detailed explanations here for why Person #1 must prioritize addressing awakenings,

I think this gives you an idea of why you want to have proper knowledge and some details when making sleep decisions.

​You can read more about our services.

Happy Sleeping,

Alissa S. Yamasaki

I'm getting around to sending this email a little later today than usual, but I just came from another productive live Sleep Q&A session. It's always nice to hear people becoming increasingly confident in their ability to sleep well and predictably, as well as feeling confident about what to do when sleep problems arise. This always makes me smile when people's fears and frustrations around sleep are put to ease.

Well, it's been a long road to put everything into place, but application for the Smart Restful Sleep online self-help program is now open. I have put this program together in order to alleviate the wait time for our services. Although it is a not a full substitute for medical care or one-on-one sleep treatment, it is appropriate for addressing chronic, mild to moderate sleep disruption. I'm excited! The application can be accessed here (it's easy) and priority is given to anyone who has been receiving these sleep-focused emails.

About the program:

The Mastering Restful Sleep program is a 12-week, self-paced, online program, with live, small group Q&A sessions. The first small group meeting is scheduled for 9/7/22 at 11am.

-The program material is suitable for adults (25 years+) with chronic, mild to moderate sleep disruption. The material is not suitable for college students or shift workers, as these circumstances require different approaches.

-Participants will learn how to be in charge of their own health data by implementing a structured plan for sleep change.

-Upon completion of all learning material, participants will have gained confidence in their understanding of the mechanisms of good sleep. If the techniques are followed diligently, students will experience a "resetting" of sleep patterns and develop a new relationship to their sleep. Participants will have completed several iterations toward their ideal sleep formula by the end of the 12 weeks.

-For the Sept 2022 Cohort, I have bundled the program with the cost of Good Sleep 101 as well as extra Sleep Q&A sessions (December and January) at no additional cost.

-This is often an appropriate alternative for people who are waiting for one-to-one sleep services at Ayama. We are pretty full at this point at the office, and the most likely scenarios is that the next openings will not be until October at the earliest.

What to expect:

1) You have access to online lessons to complete at your convenience. Lessons are brief and easy, with a learning format primarily of light reading, helpful graphs, and some short videos and downloadable handouts.

2) Every 1-2 weeks at 11am on Wednesday's, there will be live Sleep Q&A Zoom sessions (7 total), with me as facilitator, with plenty of opportunity to ask questions. These sessions are optional, but people who benefit from the program most will have attended at least once per month. I love these sessions, as we all practice kindness, patience and gratitude for our sleep process and the body's incredible ability to start to sleep well. Importantly, we have fun and encourage each other to practice the grit needed in the process. Everyone will have their own unique sleep challenges and the diversity of problems that we discuss facilitates learning for the whole group.

Attendance to at least one session per month from September through November will best facilitate change, but is not required. We will not meet the week of Thanksgiving. All Sleep Q&A sessions (7 total) will be held for one about an hour from 11am EST.

3) If possible, Sleep Masters (those who have completed the program as a member of a previous cohort) may pop in and join our Sleep Q&A sessions as their schedule allows. They are a wealth of their own knowledge, so it would be a privilege if some are able to join us at times. This mix of experienced and "newbie" students has worked out really well and facilitates learning for everyone.

Please note that all participants are required to have taken our free, brief self-assessment and beginning tutorial to ensure that behavioral approaches are appropriate for your sleep situation. Take this before you apply.

If you wish to read more about the program, including exact dates of the live Sleep Q&A sessions, the details are available on the program website.

If you are ready to jump into application (no obligation to pay/register if accepted), the application link can be accessed here. I will close the application availability on 8/31/22 at 11:59pm EST.

Happy Sleeping,

Alissa S. Yamasaki

We all know that making changes can be difficult at times whether it is a small mindless habit or a decades-long habit.

You may have heard that CBT-I can be rough. I also warn people in the self-help courses that sleep change requires "grit," implying that you have to be ready to persevere through difficult times.

One of the mindset barriers that people face is believing that they must get a certain number of hours to sleep in order to function. While it is true that our bodies function best at a certain amount of sleep...this amount can vary greatly between individuals (despite that you may have heard otherwise).

Therefore, setting your sights on a particular amount of sleep without really knowing how much your body needs is a mistake. I cannot tell you how many people, including myself before I knew better, believe that their body needs more sleep than it does. You cannot know how much your body needs if you are making estimates on poor quality sleep or irregular sleep patterns.

One way start to hone in on the true amount of sleep you need is through the use of a technique, which carries an unfortunate name that I believe unnecessarily incites anxiousness, called "sleep restriction."

"Sleep restriction" is the technical term for purposefully setting your sleep schedule to be shorter than usual (we choose a time that is fit to your body's ability to sleep, so it's not a standardized number).

Anxious minds will hyperfocus upon the word "restriction" but that is misguided. Sleep restriction leads to beautiful things AND is not necessarily as awful as people tend to anticipate. Mindset plays a huge role. This topic also came up in a last month at a Sleep Q&A session, so it's fresh in my mind.

What I hear people say is something along the lines of:

"I thought that I would really be suffering while getting less sleep on my new sleep schedule. Actually, I'm getting less sleep, but it's not that much less. AND, I am surprised that I don't feel worse. I mean, I'm dragging right now, but my sleep quality is better. I can feel that something is different [in a good way]."

All I can say is "YAY!"

That is a sign that everything is on the right track. It suggests the presence of a GREAT prognosis. There is other work to be done, but that will fall into place with some diligence and effort.

So, the takeaway today is to consider that sometimes challenging changes can lead to good things and are not always as hard as we anticipate.

Updates on openings: We continue to be full for one-on-one new client openings for CBT-I, but anticipate that some new openings will come around in a month or so. I am also planning to open up registration for the online self-help program for chronic sleep disruption later this month, so just stay tuned if you are interested.

If you wish to get a jumpstart on learning about sleep at this time, reply to this email, and I can send over a coupon code to access Good Sleep 101 for no cost. It's part of my mission to help make sleep information readily available to others.

​​You can read more about our services.

Happy Sleeping,

Alissa S. Yamasaki

On the surface, difficulty staying asleep or returning to sleep seems like it would be an easy fix. Without knowing sleep information, I am fairly certain that I would look to things that would "knock me out" and/or remove all disturbances.

I understand the desire to just get the problem fixed with whatever seems to work, but I actually recommend to people that they not move into ANY "fix" until they have assessed the problem.

Let's first talk about what is normal for awakenings.

It's typical to have awakenings the second half of the night for a few minutes while we stumble to the bathroom in a half-awakened state. It's not typical to have awakenings which are associated with a pounding heart, panic attack feeling or with regular morning headaches.

If you have regular awakenings during the night or a lot of sleepiness during the daytime despite sleeping through the night, then you will want to make sure that you don't have sleep apnea. It's more common than you think. Stats cited by Cleveland Clinic suggest that perhaps 25% of men and 10% of women have it.

Risk factors and signs include:

Obesity, but people without obesity also can have it.

Snoring, especially if someone has witnessed you stop breathing, is a sign.

So are morning headaches.

So is high blood pressure.

And so are awakenings during the night.

What should a person do? I don't love the word "should" because I don't enjoy putting obligations on myself or others, but this is one of those important "should's." The best way to test for apnea is through a sleep test. You don't have to go to a sleep lab. Your family doctor can usually just order a home test for you. If your home test results are negative, but you still suspect that you have it, then you should request a sleep lab test.

Why is a sleep test important? Basically, when you have apnea, you stop breathing. This can be briefly or it can be for longer than that. It can be for a couple of times a night, or many times in an hour. I've seen all varieties. During those times that breathing stops, your body isn't getting oxygen, so your risk of stroke and heart attack are greatly increased.

Before doing any insomnia work, I always ask people to consider if they need a sleep apnea test. I actually go as far as refuse to work with people who have strong signs of it and haven't yet been tested; while I want to help people find good sleep, I don't want to increase your ability to sleep without awakenings if you have apnea; it's important to have those awakenings if you aren't breathing at times during the night, and I don't want to interfere with that.

If you think some of the symptoms sound familiar (like snoring), then it's time to ask your physician about it. Your physician can help you decide if your symptoms warrant further exploration.

If you have frequent awakenings during the night but have no signs or symptoms of apnea, then we can address that type of restless, disrupted sleep with behavioral interventions used in CBT-I and in our online programming.

As always, we continue to offer free access to a short sleep self-assessment and tutorial, which does include a section on apnea. In the next week or two, I am planning to be able to open application/registration for our online self-help program for chronic sleep problems. Our one-on-one slots are currently full, but I will update you as new ones become available.

​You can read more about our services.

A friend thoughtfully passed along an article from Harvard Health (from Harvard Medical School). The content pleased me, despite that the stats are staggeringly concerning.

The article cited the finding that non-depressed people with insomnia have a twofold risk to eventually develop depression compared to people with no sleep difficulties, as shown in an epidemiological longitudinal study of the relationship between insomnia and depression.

The article encouraged the consideration of CBT-I treatment of insomnia as a preventative measure for depression, including for older adults. It also cited an article published in JAMA which showed that CBT-I was more effective than a sleep education program.

As you can imagine, this last part DELIGHTED me to read.

Takeaway messages:

1) There isn't going to be a single answer as to whether we should work on depression or insomnia first. Based upon the research, it sounds like if the depression developed after you developed insomnia, it make sense to treat the insomnia and see if that helps mood.

2) If you suffer from sleep disruption, you really don't want to let it go unchecked for an extended period of time, as you risk the development of depression.

3) You don't just want to learn some general information about sleep, as that is not sufficient; you want to consider if you are a candidate for CBT-I.

Lastly, if you need to talk someone immediately because you are having thoughts about suicide, then reach out to the National Suicide Prevention Lifeline for immediate help: 1-800-273-TALK or use the newly-implemented suicide hotline number: Just dial 988.​

I love research, data and understanding the body:)

​You can read more about our services.

Happy Sleeping,

Alissa S. Yamasaki, Ph.D.

I recently gave a poll on sleep problems. The two problems that people identified wanting to hear more about were 1) falling asleep and 2) restless sleep. Believe it or not, those two things are related and can go hand-in-hand. It reminds me of a recent Sleep Q&A session that we had. Read on...

I get the following question fairly frequently, and it relates to falling asleep and restless sleep. It was asked at one of our recent Sleep Q&A sessions:

"I am trying not to clock-watch at night because it makes me anxious. I've been trying to follow the course's recommendation to get out of bed when I cannot sleep. I was surprised when I thought it had been about 20 minutes, but it had actually been about an hour when I looked at the clock!"

The 20 minutes that is referenced by the group member is the standard rough estimate of time that is recommended for people to get out of bed when they cannot sleep (there are a lot of details that go into that recommendation, but that's the short version).

Do you know why there is such a difference in the perception of time that had passed? Has this ever happened to you? This is an important point that you want to know if you have trouble falling asleep or trouble with restless sleep.

Although I'm obviously not there while you try to sleep, my best educated guess is that when a long time goes by in bed, you are probably actually going in and out of very light, early stage sleep. It is hard to recognize that you are dozing. This is the same reason why people get into motor vehicle accidents by falling asleep at the wheel of a car. We aren't particularly good at knowing when we are entering the early stages of sleep.

The consequences are actually pretty significant regarding nighttime sleep when you start to get that light sleep without knowing it. Getting that light sleep, followed by being alert and aware that you are awake (such as when you look at the clock or start to think about something consciously), sets up the body to have difficulty falling asleep in a solid, satisfying manner for the night, sets you up to feel like you didn't/can't fall asleep, and also sets you up to have the kind of night that includes a lot of "tossing and turning" that leaves you feeling like you had restless sleep.

In order to get rid of difficulty falling asleep and replace the sense of "tossing and turning" with deeper, more satisfying sleep, then you must understand how and when to get out of bed. A good place to start is to get out of bed when you sense that it has been a while and you are still somewhat awake. My prediction is that it will be longer than 20 minutes. Test it and see for yourself. After 20 minutes, you are basically training your body to be awake in bed, and you want to minimize reinforcing the body to be awake in bed if you truly want to sleep well.

If that sounds awfully hard to get out of bed, yes, it's not the most pleasant. It is important to know that the technique works best when used in conjunction with solid knowledge of what is going on within the body to prepare and help sleep work well.

Wish to start to learn more about the mechanisms of sleep? Consider our short course, Good Sleep 101. If you are a woman who is 40+ and dissatisfied with sleep, then you are also invited to apply to join our next cohort of students for the Mastering Restful Sleep program which starts in September.

The Mastering Restful Sleep Program merges sleep physiology, behavioral principles, and mindfulness/self-compassion approaches to address chronic sleep dissatisfaction. Good Sleep 101 is included in the program fee. I will be announcing the opening of the program publicly in August. If you wish to have early notification prior to public opening of the program, sign up for our sleep newsletter. Admission is by application and on a rolling basis.

​You can read more about our services.

I am so curious to know if you agree or disagree when I say, "I wouldn't call a 4-hour night of sleep bad.” I realize that it is a provocative statement, and I don't necessarily enjoy a short night of sleep, but there is an important function of a 4-hour night of sleep for which I have deep gratitude.

This topic is on my mind because we have our "newbies" starting out in our self-help group for chronic sleep problems. When making sleep changes, especially in the beginning stages, it's important to grasp the idea that we don't have to catastrophize a short night of sleep.

When you understand the mechanisms of how good sleep works, then you also understand that technically, a 4-hour night of sleep is “short” and not “bad.” Short nights of sleep actually set up the body to be followed by a night of high-quality sleep.

The reason for this is that a short night of sleep maximizes something called “sleep drive." Sleep drive is why people often yo-yo between "good" and "bad" nights of sleep. We can learn to collect our sleep drive in a way that allows us to have consistent ease in falling asleep and staying asleep.

In contrast, we can also sabotage sleep drive inadvertently, creating sleep that is broken, restless, low quality, and yo-yos between high quality and low quality.

I have lots to say on this topic...but if I have to choose one area that may be relevant to a lot of people, it would be to practice mindfulness about your assumption or language around calling a short night of sleep "bad." Some alternatives include "inconvenient" or "challenging" or just plain, "short." AND, remember that a short night of sleep sets up the body for restful sleep.

Want to know more? Sleep drive is a topic and cornerstone of sleep knowledge needed when it comes to addressing sleep disruption. We continue to have one-on-one openings for CBT-I, and I've added some new info on our website, including some example sleep stats that we track in CBT-I. I'll open up registration for our online self-help course in August and am planning to keep it small and personal.

​You can read more about our services.