5 stars for curing my insomnia! -1 star for taking a slightly insulting approach to the reader.
This book goes far beyond the generic advice on sleep hygiene (eg. importance of sunlight/darkness, no phone in bed, evening wind down, no caffeine after noon, don't nap) and introduces Cognitive Behavioural Therapy for Insomnia (CBT-I).
What I learned (advice applicable to all genders):
- Brain training: You need to train your brain to associate your bed with sleep. This means that your bed is for sleeping only, and only go to bed when you are really sleepy.
- Sleep journal: Keep a sleep journal for 2 weeks. Record the following: when you went to bed, how long it took you to fall asleep, how many awakenings you had in the night and for how long, when you woke up, when you got out of bed. From this, you can calculate a Time in Bed and a Total Sleep Time.
- Do not check the clock overnight. You can make rough estimations for the above (i.e. subjective 'felt time')
- Sleep restriction: You then take your Total Sleep Time average, and this is your new hours of sleep that you're allowed per night. For the next two weeks you restrict yourself to this amount of time in bed (eg. if your Total Sleep Time average was 6 hours, now you only allow yourself to be in bed for 6 hours). This resets your relationship with your bed and bedtime in general - now you will be genuinely exhausted at bed time and likely be out like a light.
- Don't drink much in the hours leading up to bedtime.
- Don't have a bath right before bed (your body needs to be cool for optimal sleep). Take a bath ~2 hours before bed.
- Stick to a fixed bed time and wake time. Don't sleep in, don't go to bed early. You can't bank up sleep on the weekend.
- You won't always have great sleep every night. This is normal. Don't freak out about it.
- There's a whole range of advice, including on medication, herbal supplements, hormones, perimenopause and menopause, pregnancy, etc. I found the above dot points most useful.
Within a really short period of time of reading this book (~4 days) I seem to have reset my sleep! I have tonnes more energy and am feeling balanced, sane, happy??!! After years of having agonising 2am-4am insomnia. So this is really quite something. The concept of sleep restriction never crossed my mind - at first it seems so counterintuitive.
Problems I had with the book:
- It has a pretty old school idea of the kind of problems that women face. Whenever examples are given of what kind of thoughts women might ruminate over they are extremely domestic, eg. "I need to go to the dry-cleaners", "Did I pack my son's lunch", "When am I going to get time to go grocery shopping". After enough repetition this really grated against me. Women have real problems and concerns beyond when we are going to get the ironing done!
- The CBT-I advice is revealed quite slowly, and in a bit of a patronising way that doesn't reveal the mechanisms/principles at play.
Overall though, I have to thank the author. It's an enormously helpful resource. Thank you.