Hi, I'm Christina Quinn. Welcome back to Try This from The Washington Post. This is the fourth of five classes in our sleep course. In our last class, we introduced the concept of soothing distractions and things you can do to fall back asleep in the middle of the night. This time, we're going to lift up the duvet and dig into the concept of sleep drive. This idea is new to me, and now I'm obsessed with it. What have I told you that your sleep drive was the reason you keep waking up at night? That maybe you need to increase your need for sleep? I know that sounds counterint, if you're thinking, What? But I'm exhausted. Sleep drive is an appetite for sleep. It grows throughout the day, peaks late at night, and then dissipates quickly once you fall asleep, like when you eat a meal and are no longer hungry. Sleep drive is separate from your circadian biological clock, but they are in a coordinated dance with each other. Your circadian clock helps your body understand when it you go to bed and is controlled by a part of your brain that responds to light and darkness.

But if you think about how much artificial light surrounds us throughout the day and into the night, it can be really tough to reset our circadian rhythm. Sleep drive, on the other hand, is pretty simple to adjust with one technique that has worked for many patients of Lisa Strauss. Lisa is a sleep therapist, and been hearing from her throughout this course. The technique that she recommends is called sleep compression.

It works so often. It works so well. Often people come in who have had sleep trouble, no exaggeration, for decades, and I'll have them gently compress their sleep opportunity, and it works really well for them.

Sleep compression is a cognitive behavioral therapy that's been used to treat insomnia for decades. The idea behind it is to set parameters around when you go to bed and when you get up for the day. So, for example, you'll go to bed at 11:00 PM and wake up at 6:30 AM every day. It's a gentler version of sleep restriction therapy, which involves mild sleep deprivation with more rigid time limits. But Lisa doesn't want to deprive you of sleep. She does, however, want you to experiment.

Sleep compression is not meant to sleep deprive you at all. It's just meant to compress your sleep opportunity to a more realistically sustainable quantity.

Now, before we dive in, I want to remind you that Lisa is a metaphor queen. And she is going to go deep with an analogy here like Deep crust Deep.

So the way I think about it is this. You picture a ball of pizza dough and imagine that this ball of pizza dough represents your sleep. It's the amount of sleep that your body is capable of right now.

You got that? Sleep is a ball of pizza dough.

And in fact, we're not capable of the same amount every night. We don't even need the same amount every night. So I'm speaking in terms of some rough average. But if you take that ball of pizza dough and you roll it out onto a small cutting board, you can picture that you're going to have nice thick dough all the way around because the surface area of the cutting board is well suited to the volume of the dough.

I'm not getting sleepy yet, but I could really go for a slice.

Now, in real life, the size of the cutting board is the time interval from when we first fall asleep at the beginning of the night to when we finally awaken for the day.

So in this analogy, if a cutting board is too big, aka, you have too many hours you're stretching your sleep out over, your dough isn't going to look so great. It'll be thin, stretched with holes where there shouldn't be holes, but you want pillowy dough.

And that nice thick dough corresponds to nice, deep, restorative sleep that's relatively uninterrupted. Even the very best sleepers are going to awaken roughly every 90 minutes. They may not remember the wakings. They may just roll over, go back to sleep. Nonetheless, even under optimal circumstances, there are going to be a few little toothpick-sized holes in that dough. But roughly speaking, small cutting board, thick dough, good sleep.

Okay, grab your apron. We're going to get rid of those holes in your dough and create some thick pizza dough sleep. First, you'll need to establish a set bedtime. The idea is to squish all of your sleep drive into one night's rest. That could mean going to bed later than you usually do, but make a decision on when you're going to bed and what time you will get up. For example, start with a goal of say, seven to seven and a half hours of sleep. Lisa says that it is key that you do this for eight consecutive nights.

The eight nights in a row is important. You want to do these consecutively because you don't want to worry about what happens night one, night two, night three. You want to see how your body adapts to the in-position over time. But you might choose, for example, 11:00 PM and 6:30 AM, only on the assumption that those times are pretty compatible with your natural biological rhythm. We're not trying to shift your rhythm at the same time or to give you sleep problems as a result of choosing the wrong bookends. But let's say those bookends are pretty simpatico with your rhythm.

So using this example, for eight days in a row, you would not fall asleep before 11:00 and wake up past 6:30. You can fall asleep later than 11:00. You can awaken for the day earlier than 6:30. But the one and only rule of the experiment is no sleep before 11:00 PM and no sleep after 6:30 AM. This also means no napping and no hitting the Snooze button because that would mess with the sleep drive that you're trying to establish. Be sure to keep track and take notes of how you're feeling throughout this time. Remember, this is an experiment, and in the first round, you may quickly figure out what's working and what isn't.

You will need to do a series of fine-tuning experiments potentially because you may not have chosen the optimal bookends. You might need to squish more or less in subsequent experiments, but they might not need to be eight nights in a row. You might be able to determine more quickly what's working best for you.

And the long-term goal is not to rely on the schedule, but to be tuned into your body's rhythm so that you can fall asleep when you're tired, stay asleep, and wake up when it's time to wake up without needing to stick to a strict schedule.

You want to listen to your body more and you don't want to feel bound by the clock.

Clock. Enough. Come on.

So what you're going to want to do, probably for both psychological and practical reasons, is to implement rather flexibly some nights we want and need more sleep than other nights. We don't want to be paying ultra-close attention to the clock, but we do want to have consistently timed sleep because we know that that's actually really helpful for sleep. So we don't only not want an overly generously sized window, but we do want fairly consistent timing to our sleep.

And sometimes you just want to stay out late with your friends. But once you establish what your optimal sleep parameters are from your experiment, you'll know what to do if your sleep starts to fragment again because you'll have your notes to refer to.

You look up what you've written down, you implement it a little more strictly for a while, you get the sleep back on track, you live and you learn, you figure out what you can and can't get away with, and you go on with your life.

Okay, cool. So experimentation, flexible, be easy on yourself. It's going to be okay. There's another night ahead of you.

Always.

Before we wrap up this session, it's worth mentioning that sometimes this method might not work for you. Lisa says there are a couple of scenarios where she would have the patient quit the experiment early.

For example, if it's making them too anxious, if the knowledge that they have fewer hours coming to them for sleep or that the alarm clock is going to ring in X hours. A second circumstance under which I would advise them to abandon it early as if it's making them feel ill. It's one thing to soldier through the odd contrived nature of an experiment like this, and maybe at first to suffer with a little bit of sleep deprivation or the inconvenience of it. It's another thing to not be okay to feel ill, and to be cumulatively more and more exhausted as the experiment goes on.

Okay, let's recap. Waking up and not being able to fall back asleep in the middle of the night is the pits. So maybe your internal rhythm needs a good reset. That's where sleep compression could help. You're going to establish a sleep schedule that involves a set bedtime and an alarm clock wake up. And you're going to do this for eight days straight. That means no naps, and no going to bed earlier than the time you committed. Sure, you may feel a little more tired than usual in the first couple of days as your body adjusts, but keep your eye on the prize. The payoff could be solid, consistent sleep. Take notes about how you're feeling over the span of this experiment. What works? What doesn't? After eight days, you may find yourself sleeping through the night. And if not, try the experiment again and play with your parameters a bit. The fact that you're making the effort to do this is great, for real. Up next on the final class of our sleep course, what to do when you think melatonin could be the solution you're looking for? We'll be back next week. But if you're a Washington Post subscriber, you can access the fifth class right now by connecting your subscription to the Washington Post channel on Apple Podcasts.

If you're not yet a subscriber, go to washtonpost. Com/subscribe or look for the link in our show notes. If you love the show, leave us a review on Apple Podcasts or email us at trythis@washpost. Com. I'm Christina Quinton. See you in our final class.