Can't get to sleep? Stay up

Reuters

STAY UP: Researchers at Auckland University have discovered a potential breakthrough treatment for insomnia.

Researchers at Auckland University have discovered a potential breakthrough treatment for insomnia that is cheap, effective and could spell the end of sleepless nights for hundreds of thousands of Kiwi insomniacs.

And paradoxically, the key to the treatment is to force bad sleepers to spend less time in bed.

The treatment is a kind of talking cure a technique so simple it can be taught to patients by GPs or practice nurses, and which can free insomniacs from their dependence on sleeping pills.

Patients are first told to keep a detailed diary of the time they spend in bed asleep and awake. They are then told to change their habits, reducing the time they spend in bed each night by the number of hours they would usually spend lying awake. After a couple of weeks of this sleep "deficit", many patients discover they are tired enough to start sleeping better.

The team has just completed analysis of a pilot study into the treatment. The results were impressive and have already excited interest from the prestigious British Medical Journal, which has published details.

Senior lecturer Tony Fernando, who led the study, said the results had huge public health consequences if adopted by GPs.

"It means the millions we spend on drugs, herbal medicines and special mattresses looking for an answer can actually be solved by something very simple."

Fernando's study of 40 participants over two years targeted primary insomniacs those whose insomnia has no obvious cause such as depression, anxiety or other sleep disorders.

It is believed up to 10% of New Zealanders some 400,000 people may suffer from primary insomnia.

When the insomniacs in Fernando's study underwent a four-week "sleep rescheduling protocol", 80 to 90% said their insomnia had improved. This result was so overwhelming Fernando was able to conclude the technique worked even though the study had a relatively small sample size.

For the first two weeks of the treatment, study participants were required to complete a sleep diary. "From that we estimate the actual total sleep time, which is different from the total time spent in bed." Typically a patient would spend eight or nine hours in bed but sleep for just five.

Patients were then instructed that for the next two weeks they were allowed to stay in bed only for the duration of their sleep time.

"If they were only sleeping for five to six hours, they were only allowed to stay in bed for a maximum of six hours. It is counter-intuitive people with sleep problems often spend longer in bed and go to bed early hoping to get to sleep.

"But if the brain is not ready to sleep, it won't sleep. This is about retraining the brain to sleep again.

"A lot of insomnia patients don't feel sleepy at 9, 10 or 11pm like most people. One way to make them sleepier is to delay bedtime. But people don't think like that; they think they should go bed earlier."

Fernando said if a patient followed the regime for two weeks, they would accumulate a sleep deficit that would reach a certain point where it would be strong enough to enable them to go to sleep.

Some study participants were so pleased with the results they dubbed them "a miracle cure", saying they slept better and had more energy.

A larger study, funded by the Health Research Council, targeting a broader range of participants has begun. It aims to improve the statistical significance of the original study, as well as pinpoint any side-effects.