Blog post 20 June 2019

The Worst Sleep Myth

Sleep myths 1 through 4 are in the previous post (dated from 20 May 2019), where I promised I’d get back to one of the worst myths.

Two closely related myths are: “Lying in bed with eyes closed is almost as good as sleep,” which leads to this claim: “ If you have difficulty falling asleep, it’s best to stay in bed and try to fall back to sleep.”

In fact, the opposite is true. Staying in bed a lot when you’re awake is one of the key causes of chronic insomnia. If you can’t sleep after 20 minutes, get up and do something boring or soothing until you’re sleepy again, and then go back to bed. This is one feature of Behavioral Therapy for Insomnia.

Rest and sleep are not the same thing, and do not give you the same benefits. Sleep serves particular physical needs: the body heals, waste products in the brain get cleared out, and memories get consolidated. Rest does not give you those specific benefits. Rest is important for your muscles to recover when you’ve been physically active, and for your mind to rest from work or chores so that you don’t burn out.

And…you can rest just as well in a chair or couch as in your bed, without increasing your risk for insomnia.

If you have had a recent brain injury, rest is absolutely vital. Staying off of phones and devices is important, to allow your brain to recover physically from the injury. Back in the day, doctors used to tell people to stay awake after a concussion – we now know that is wrong. Resting the brain allows it to heal. So if you get up out of bed after 20 minutes of not sleeping, do something restful and soothing out of bed, e.g., on a chair or couch.

If you have bipolar and you begin to feel like a hypomanic or manic episode is just starting to come on, rest in a dark place can be helpful in keeping your mood from elevating further. This is the opposite of what hypomania or mania makes you want to do, which is why it’s effective. So if you get up out of bed after 20 minutes of not sleeping, keep the lights off in whatever room you’re in. Again, do something restful and soothing that does not require light. If you are going to put lights on, wear a pair of blue-light-blocking sunglasses.

To illustrate how badly this myth can affect people, I’ll share the example of an older male relative of mine, not a client, who lives on the East Coast. We’ll call him Dave. Dave was having a lot of trouble sleeping, and went to a doctor. The doctor actually told Dave that it was important to stay in bed when he couldn’t sleep. Too bad the doctor didn’t know the science of sleep!

Over three years, Dave’s problems sleeping got worse. He was spending more and more time in bed, and taking long naps in the afternoon. He never slept more than 2-3 hours in one block, and was often awake when his wife was asleep.

Finally, I persuaded Dave to see a sleep psychologist. (It’s not ethical for me to work with people I know, and certainly not family members.) The psychologist corrected the misinformation the doctor had given him, explaining why staying in bed more than 20 minutes when awake can cause insomnia. Dave followed the advice to get out of bed when he couldn’t sleep, and within 4 weeks, his insomnia resolved. He sleeps well now, and is so grateful that he got the right information.

After that, he called me up and said, “You must have a tough time in your field, if doctors are giving people the wrong information.” I agreed, though I pointed out that board-certified sleep MDs would know better. We sleep professionals have to work constantly to correct misinformation about sleep. Part of our professional and ethical duty is to get people valid, scientific information about sleep so that they can get their nights and days back on track.

I’m very grateful to the authors of the article in Sleep Health for publishing this research. I hope this blog can help keep my readers from suffering the way Dave did from sleep myths.


Source: Robbins et al. (2019). Sleep myths: An expert-led study… Sleep Health.
https://doi.org/10.1016/j.sleh
2019.02.002