Sleep quality: why quantity isn’t everything
Spending more time in bed does not guarantee better rest. On the contrary, when sleep is disrupted, staying awake in bed for long periods can weaken the association between the bed and sleep. As a result, falling asleep becomes more difficult, nighttime awakenings increase, and feelings of fatigue persist upon waking.
The goal is therefore not to sleep longer, but to sleep better. Sleep quality depends in part on continuity, depth, and the actual time spent sleeping compared to time spent in bed.
Is it necessarily insomnia?
It is normal at times in life to experience difficulty falling asleep or to have less restorative nights. This does not automatically mean that you have insomnia. Insomnia is a health condition defined by specific diagnostic criteria.
Self-diagnosing too quickly can even increase concerns about sleep and worsen the situation. As soon as sleep difficulties appear, however, it is helpful to implement strategies to promote better rest and prevent the issue from becoming persistent.
Sleep restriction therapy
Sleep restriction therapy aims to realign the time spent in bed with the actual time spent sleeping. When feeling fatigued, it is common to try to “catch up” on lost sleep by going to bed earlier, waking up later, or taking naps. Paradoxically, these behaviors often maintain sleep difficulties.
For example, consider a person who goes to bed at 10 p.m. and gets up at 8 a.m. They take about two hours to fall asleep, wake up several times during the night, and remain awake in bed in the morning. Although they spend ten hours in bed, they actually sleep only about six hours.
Steps of the technique
- Assess actual sleep time
- Adjust time in bed to match that number of hours
- Gradually reduce this duration to allow the body to adapt
In this example, the person would therefore go to bed for approximately six hours instead of ten.
For more information on sleep restriction therapy, you can consult this document available on the tccmontreal website.
Goals and expected effects
By temporarily limiting time spent in bed, sleep pressure and perceived fatigue increase, which promotes deeper and more continuous sleep. During this period, it is important to stay active during the day and avoid naps.
Once sleep becomes more restorative and stable, time spent in bed is gradually increased until it reaches a duration that meets individual needs, generally between six and nine hours per night.
Precautions and professional guidance
Sleep restriction therapy can cause temporary daytime sleepiness. It is therefore recommended to be cautious during activities requiring sustained attention, such as driving or cooking. If sleepiness becomes too significant, a short nap may be allowed, ideally before 3 p.m. and lasting no more than 45 minutes.
This approach may be contraindicated in certain situations, including anxiety, depression, epilepsy, or restless legs syndrome. If in doubt, it is best to consult a healthcare professional before starting.
Sleep restriction therapy is generally more effective when carried out with the support of an mental health occupational therapist, who can adjust sleep duration, ensure safe follow-up, and suggest other appropriate strategies.
Medication and sleep
Scientific evidence shows that sleep medication is often less effective when used alone. When combined with a cognitive behavioural approach, including sleep restriction, it can help reduce the time needed to fall asleep or nighttime awakenings. Medication is generally recommended for short-term use only.
Conclusion
Sleep restriction therapy can be an effective tool for improving sleep quality and restoring more restorative rest, provided it is well supervised and tailored to each individual’s situation.
For personalized support, PhysioExtra professionals, particularly in mental health occupational therapy, can help you better understand your sleep difficulties and implement safe, sustainable strategies.
