Less time in bed gets better sleep in primary insomnia

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Goodfellow Gems

"Less time in bed gets better sleep in primary insomnia"

About 12% of patients with insomnia in primary care have primary insomnia i.e. that is insomnia with no other causes such as depression or sleep apnea. Patients with primary insomnia spend more time in bed than they need. Spending fewer hours in bed improves their quality of sleep very quickly. An RCT has found that a simplified sleep restriction (SSR) intervention – to restrict time in bed – is effective in improving insomnia over 6 months when delivered by GPs.1 For SSR, total time in bed allowed initially was equal to the average total sleep duration plus 50% of the total time spent awake in bed (therefore reducing the total additional ‘wake time’ by half), with a minimum time in bed of 5 hours. The numbers needed to treat to get an improvement was four. For how to advise time in bed restriction see ref 2.

References:

  1. Karen Falloon, C Raina Elley, Antonio Fernando, Arier C Lee, Bruce Arroll
    Simplified sleep restriction for insomnia in general practice: a randomised controlled trial Br J GP august 2015 http://bjgp.org/content/65/637/e508

  2. Falloon et al BMJ http://www.bmj.com/content/342/bmj.d2899

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.


As published in NZ Doctor 02/09/2015