The best way to beat insomnia

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RICHMOND, VA.--Insomniacs get lots of advice: Cut down on caffeine and alcohol, follow a regular schedule, and don't stay in bed if you can't sleep. But it's never been clear what strategy works best.

To find out, clinical psychologist Charles Morin, at Virginia Commonwealth University, looked at 59 sleep studies from the last 20 years. He compared a variety of therapies, including relaxation techniques, bedtime adjustments, and such familiar strategies as avoiding late-evening exercise and keeping morning light out of the bedroom. Morin rated the techniques by how long it took insomniacs to fall asleep and by the amount of time they spent awake during the night.

Oddly enough, although all the treatments helped, the two that limited time insomniacs spent in bed worked best. Those who practiced "sleep restriction"--they went to bed later and got up earlier-cut the 50 minutes it usually took them to fall asleep down to 21 minutes. (People using this method go to bed earlier once they're able to snooze through the night.) Insomniacs who set aside the bedroom exclusively for sleep and sex and got out of bed if they'd been awake for more than a quarter of an hour, fared even better. They trimmed sheep-counting time by 31 minutes.

Sleep restriction, however, was the dear winner in reducing the time insomniacs spent awake in the middle of the night. On their reset schedules they clipped an hour and 15 minutes of tossing and turning, much better than the 40 minutes for the sleep-and-sex-only crowd. Avoiding late-evening exercise, along with other simple changes, cut 22 minutes; relaxation techniques lopped off just 19.

Morin thinks that sleep restriction works because it helps to eliminate the frustration of lying awake in bed. "The pressure to fall asleep disappears when you're told you can't go to bed before two A.M.," he says.

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By John Hastings, Patricia Long, and Michael Mason

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