Shorter time in bed may protect against acute, chronic insomnia

Data presented at the SLEEP 2016 annual meeting suggested shorter time in bed may have a protective effect against incidence of acute insomnia and therefore chronic insomnia.

“Those with insomnia typically extend their sleep opportunity,” Michael Perlis, PhD, of the Penn Behavioral Sleep Medicine Program, University of Pennsylvania, said in a press release. “They go to bed early, get out of bed late, and they nap. While this seems a reasonable thing to do, and may well be in the short term, the problem in the longer term is it creates a mismatch between the individual’s current sleep ability and their current sleep opportunity; this fuels insomnia.”

Michael Perlis

As part of an ongoing study of the natural history of insomnia, researchers prospectively assessed sleep diaries from 539 individuals over 6 months. Data were available for stable good sleepers (n = 394), good sleepers that transitioned to acute insomnia and then recovered (n = 36) and good sleepers that transitioned to acute insomnia and then chronic insomnia (n = 31).

During the good sleep phase, stable good sleepers had shorter time in bed than the good sleepers that transitioned to acute insomnia and then recovered. Time in bed did not significantly differ between the good sleepers that transitioned to acute insomnia and then recovered and those that transitioned to acute insomnia and then chronic insomnia.

During the acute insomnia phase, time in bed was shorter among good sleepers that transitioned to acute insomnia and then recovered and longer among those who transitioned to acute insomnia and then chronic insomnia, compared with their good sleep phases.

“Acute insomnia is likely a natural part of the human condition. If you think about the fight/flight response as trigger for sleeplessness, this makes sense. That is, it shouldn’t matter that it’s 3 a.m. and you’ve been awake for the last 22 hours, if you’re being threatened and you believe there is a threat to your quality of life or existence, it’s not a good time to sleep. It is understandable that sleeplessness has persisted as an adaptive response to such circumstances,” Perlis said in the release. “In contrast, it’s hard to imagine how chronic insomnia is anything but bad...and clinical research data support this position given chronic insomnia’s association with increased medical and psychiatric morbidity.” – by Amanda Oldt

Reference:

Perlis ML, et al. The natural history of insomnia: Does the 3^rd P of the 3P model differentiate between recovery and the transition from acute insomnia to chronic insomnia? Presented at: SLEEP Annual Meeting 2016; June 11-15; Denver.

Disclosure: Perlis reports receiving support from NIH R01AG041783. Please see the full study for a list of all other relevant financial disclosures.