Episode 65

Intensive Sleep Retraining

What if you could jumpstart your sleep in just one intense weekend to fall asleep fast and get more sleep?

In this  episode, I discuss the relatively new intervention for insomnia known as intensive sleep retraining - what it is, how it’s done, and whether it even works.

Is there a surefire quick-fix way to eliminate insomnia? The answer is still a hard no, but there are some promising, though preliminary results. 

Intensive sleep retraining may be beneficial for a minority of patients. By forcing sleep deprivation and repeatedly teasing you with sleep, ISR aims to re-establish the connection between the experience of falling asleep, with the reinforced awareness of falling asleep. When repeated dozens of times across a weekend, intensive sleep retraining does boast some results. 

With only 66 patients studied in a standardized protocol, only 39 of them in a randomized fashion, it's hard to extrapolate. However, ISR does seem to consistently improve the time it takes to fall asleep, improve the total amount of sleep achieved, improve sleep efficiency, and improve insomnia symptoms and daytime function - no one can argue against that. 

But on average in this small number of subjects tested to date, the degree of suffering still present after the intervention is hard to ignore. Even after treatment, still taking 40 to 80 minutes to fall asleep on average doesn’t sound like success to me, with an average of clinically significant moderate insomnia severity, and sleep efficiencies in the 50s-70s, it's a far cry from a home run. However, one study did report a responder rate - where individuals were essentially cured of insomnia - and a cure rate of 36% is nothing to balk at - and when combined with other well-established interventions for insomnia, that cure rate bumps up to 55%. 

And now with at least 2 home-based versions of intensive sleep retraining, there are accessible options for many more. But whether these versions done in the convenience of one’s home actually work is another thing, and with the limited data so far, it appears that this promising intervention still has a lot to prove.