As we said in Beating the Dementia Monster, the most powerful weapon against Alzheimer's disease is physical exercise - especially sustained aerobic exercise. However, some experts I've spoken with will tell you that #2 is getting adequate sleep. And in Beating the Dementia Monster, we discussed why that is. So I've put a lot of emphasis in my own battle on sleeping well, at least seven hours a night.
But I haven't slept well since early 2020. And I've tried everything. Last year, we wrote glowingly about the prescription medication suvorexant, sold under the brand name Belsomra. How did that go? In my experience, it simply stopped working after a short period of time. And then when I stopped taking it, I couldn't sleep at all. I also tried ramelteon with similar results. Except ramelteon seemed to make me depressed.
So am I out of possibilities?
I don't have any trouble getting to sleep, and I'll have been quite tired when I first lay down. But I'll be suddenly very awake an hour and a half or 90 minutes later. (These times correspond with the ends of the 90-minute sleep cycle we discussed in Beating the Dementia Monster.) Often, I could go back to bed after an hour and a half or two hours, but getting to sleep was very difficult. If I went back to bed at around 7 or 8 in the morning, I could often get another hour or so, but I have a lot of morning commitments that make this hard.
One way I fought it was by going to bed earlier and earlier. For a while my bedtime was 9 and 9:30, and then 8:30. So I would end up taking 10 hours to get six hours of sleep. Or often five hours.
I guess the YouTube algorithm began to feel sorry for me, and it started sending me links to various videos on insomnia. (It must have seen what I was Googling in the middle of the night.) One of the videos described something I'd never heard of before, called "bed restriction therapy." The video was by two Australian therapists, but after I watched it, the algorithm sent me a whole bunch more by other therapists. While I'd never heard of bed restriction therapy before, I guess it's pretty commonly recommended.
The concept is straightforward and is based on the idea that our sleep patterns are a consequence of habit. So you create a new habit by strongly limiting the time you're in bed. You want to force all of your sleep time into a single segment. In my case, I've developed a habit of waking up for long periods during the night. I've also apparently trained my brain to believe that lying awake in bed during the night for long periods of time is just part of life.
So to do this therapy, we start out with two things: How long do you actually sleep during the night, and when will you get up. The sleep time, of course, excludes the hours when you're awake. According the my FitBit, I've been sleeping a total of about five hours a night, although often a little less. I'd like to get up at six a.m., but for a long time I haven't been able to sleep beyond 5:00. So you take the time you will get up and roll the clock back the total number of hours you sleep. That's your new (temporary) bed time. So if I will be getting up at five, and I sleep five hours, I go to bed at midnight. Which is a big switch from 8:30.
And then no naps during the day ... at all.
Of course, that five hours of sleep is normally distributed over about an 8 to 10-hour period. So I will not be getting those five hours of sleep. In fact, when I started doing it, I was lucky to get three hours. And you do that for a full week.
One of the therapists said that her patients really, really hate her for that week. And I can see why. I have just finished that first week, and it was horrible. Most days, I realized I shouldn't have been driving, but I had so much to do.
They said it would be discouraging, but just stick it out for one week. They say you really need a sleep coach to do it right, someone to encourage you and help stick it out. On night six, I almost threw in the towel. But on the seventh night, I finally slept the whole five hours without waking up (except for a couple of trips to the bathroom).
The plan now is to adjust bed time in one hour increments, taking one week with each adjustment. So I'll be going to bed at 11 each night for one more week and hopefully getting up at five a.m. The following week I will go to bed at 10, which is my goal. I want to go to bed at 10 and wake up at 5 a.m. Hopefully, I'll be doing that in another week.
I sure feel great today, but was last night a fluke? They said after a week, the therapy will begin to work, and you'll begin to feel a lot better. And I feel a lot better today. We'll see how it goes.
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