#58 - What is Intensive Sleep Retraining?

If you can’t fall asleep, go to another room.

Wait till you feel sleepy. Go back to your bedroom. And try to fall asleep.

If you still can’t fall asleep - repeat the above.

These are some of the instructions for an insomnia technique called Stimulus Control Therapy.

It was invented back in the 1970s and it’s one of the proven methods for treating insomnia.

Only thing is - it takes about 4-6 weeks to do.

That’s 28 to 42 nights of UP, DOWN, UP, DOWN, UP, DOWN.

This means many people don’t stay the course and give up.

But what about if you could perform Stimulus Control Therapy in one weekend?

Flinders Accelerated Sleep Training …

In the year that another former president was impeached (Clinton in 1998), I started my journey into sleep research.

Specifically, I was in charge of a project where we asked participants to fall asleep every 30-min across an entire weekend. And as soon as they fell asleep, we woke them up.

That’s a total of 96 times that they attempted sleep during their weekend stay at our sleep lab.

Why?

The circadian rhythms of sleepiness - as measured by sleep onset latency (SOL), aka, the time taken to fall asleep. Higher points on the graph mean longer times taken to fall asleep - meaning less sleepiness.

Because at the time we were measuring the 24-hr circadian rhythms of good sleepers.

And in this case we were measuring the circadian rhythm of sleepiness (ie, how long it took them to fall asleep).

So on Saturday morning - after they had a full night’s sleep, they took a long time to fall asleep. This meant they didn’t feel sleepy.

Around 6-8 PM on Saturday, they were very alert - and struggled to fall asleep.

On Saturday night, they fell asleep just fine.

Across the entire Sunday, they fell asleep within minutes (with the slight exception of between 6-8 PM).

But the worst was on Monday - from midnight till dawn.

They would struggle to stay awake. At all.

They would fall asleep when:

• we weren’t checking on them,

• we would talk to them.

• some even fell asleep when they were chewing food (it’s not a good look!).

I ended up doing my PhD using this protocol, and looking at the links between body temperatures and sleep.

Yet, it was my PhD supervisors - Prof Leon Lack and Dr Helen Wright - who created a left-turn towards the end of this project.

Intensive Sleep Retraining

Leon and Helen religiously went to lunch together every workday. And they’d chat about all things ‘sleep’.

During one of those lunch breaks, they came up with the idea of subjecting people with insomnia to this tortuous weekend protocol.

Their reasoning was that - on the one hand - the protocol provided 96 opportunities to fall asleep.

And because the protocol prevented people from actually sleeping, their biological drive to sleep rapidly increased over the weekend.

This meant that out of the 96 opportunities to fall asleep, many of these were going to be successful sleep attempts.

Leon and Helen had re-invented a new way of treating insomnia.

They took the 4-6 weeks of Stimulus Control Therapy, and crammed it into one weekend.

And they called it FAST (Flinders Accelerated Sleep Training).

But when they went to publish the findings, they weren’t allowed to call it FAST.

So they called it ISR.

Intensive Sleep Retraining.

It was hailed by the experts as a revolution.

But like most things, there was one big problem.

How do you get a therapy from the lab to the home?

How do you know when a person falls asleep, and then have someone to wake them up?

Cutlery, Apps + Thimbles

As it turns out, it is possible to transition from the lab to the bedroom.

And if you’re reading this, we really hoped you managed to get in early enough to subscribe to our free weekly newsletter (it’s that small form’ right there; at the bottom)!

Because our subscribers learned the ways in which this transformation occurred.

And whether it works!

- Prof Michael Gradisar