Tuesday, March 09, 2010

UCSD Psychiatrist Has Program to Cure Most Insomnia

story and photo by LEO E. LAURENCE

Copyright © 2010 by Leo E. Laurence • All rights reserved

Insomnia at night can wreck your day, but a University of California at San Diego (UCSD) psychiatrist has developed a program that can cure it, assuming no physical problems exist.

Insomnia is the abnormal inability to get adequate sleep at night. Some research shows that it affects about 30 percent of the population, though that figure may actually be quite low.

“About 10 percent have such bad insomnia that it ruins their day,” says Dr. Joshua Kayman, M.D., a high-energy psychiatrist at UCSD Outpatient Services in Hillcrest, commonly known as the Gifford Clinic.

He has developed a workable program that can significantly reduce insomnia for those “who are committed to it and put some energy into it.”

Taking Control of Sleep

The comprehensive program used by Dr. Kayman is actually quite simple, with some firm rules that may change an insomniac’s daily routine in some surprising ways. Productivity increases dramatically.

First, the person keeps a daily log for one week of their sleep habits, including (1) recording their bedtime, (2) their rise time (when you get out of bed, not when you wake up), and to determine their total time from bed to rising.

Next, they estimate (1) the time it took to initially go to sleep, (2) the time awake during the night, and (3) the time lying in bed in the morning before getting up; but after first waking up. That time is deducted from their total time in bed, to determine the total “sleep time.”

The average of a person’s total sleep time for a full week establishes how much sleep that per-son really needs each night. Generally, it is longer for a younger person in their 20’s (8+ hrs.) than for a senior citizen (6+ hrs).

Then the person determines at what hour they want to get up in the morning. If, for example, that’s 7:30 a.m. and the person’s average “sleep time” is 7 1/2 hours, then that person should go to bed at midnight.

The old-fashioned rule of “Early to bed, early to rise … ” is a myth and inconsistent with the current science on the cure for insomnia.

Bed is for Sleeping or Sex, Only

Some people like to read or watch TV or make phone calls from their bed. Wrong! The bed is for sleeping or sex, only !!!

Get out of bed at the very same time, every morning. That will set your “biological clock,” according to this program used by Dr. Kayman. It is based in part on 2007 research from the University of Pittsburgh, and more recently replicated by him at UCSD/

“If you get up (out of bed) at the same time every day, it helps you to sleep better the next night,” Dr. Kayman explained.

Don’t go to bed unless you are sleepy. The longer you are awake, the better you’ll sleep.

Don’t stay in bed if you aren’t sleepy. If you go to bed and toss and turn, but don’t sleep for about 15 minutes, get up until you get really sleepy.

If you lie in bed frustrated that you are not sleeping, the bed = frustration. Stop trying to fall asleep, and it helps you train your brain that bed = sleep.

No Daytime Naps

Taking a “short” nap during the day may make you feel temporarily more refreshed, but they are murder to a good night’s sleep.

Forcing yourself to stay awake during the day helps you to fall asleep when you go to bed at night, according to Dr. Kayman.

Many people like to take “Churchillian naps,” short 10-15 minute naps mid-afternoon. WW-II English Prime Minister Sir Winston Churchill reportedly had a bed in his wartime office in London to take short naps. But Churchill was an exception.

Staying awake during the day, even when you want desperately to take a short nap, helps you fall asleep that night, the UCSD psychiatrist reports.

New Sleeping Rules

If you work this program advocated by Dr. Kayman, you will cure your insomnia, unless you have some physical problems like sleep apnea, which is the transient cessation of respiration (breath-ing).

In other words, with sleep apnea a person will literally stop breathing temporarily and wake up — incorrectly thinking they have insomnia.

1. No naps. None, period!

2. The bed is for sleeping ONLY, no watching TV (to supposedly “get sleepy”) in bed. No reading in bed. Your body and mind need to get trained that it sleeps — and only sleeps — when you get into bed.

3. Sex is O.K. in bed, but only if it is enjoyable.

4. Keep the bedroom comfortably cool at night, several degrees lower than the rooms where you live. Very warm or very cold temperatures may disturb sleep.

5. Avoid drinking water after 6 p.m. (1800 hrs.), so you don’t have to get up in the middle of the night to take a leak.

6. Booze disturbs sleep. While we will eventually get sleepy when drinking, when the alcohol wears off, you will wake up and be wide awake, unable to sleep. You will wake up one hour earlier than usual, for every drink before bedtime.

7. Coffee cooks your sleep, especially Starbucks’ high-test stuff.

8. Smoking kills sleep. Nicotine is a stimulant, so no smokes at night before bedtime.

9. Don’t go to bed hungry. Eat a light snack (no meat) about an hour before you turn in.

10. Use the bedroom only for sleep. Especially no exercise equipment! Keep it dark at night and close the door when you turn in.

11. Take off pajamas immediately after getting up in the morning. They are for sleeping only, and not to be worn during breakfast.

12. Exercise (long walk, workout) regularly! But don’t exercise three hours before bedtime.


This program works. Commit to it and put some energy into keeping a daily log of your sleeping habits. By following these simple, but firm, rules; you’ll regularly sleep at night after about two weeks on the program.

Some people resist working this program “because there is an easy fix to their insomnia and they just go with the medication (e.g., Ambien),” said UCSD’s Dr. Kayman in an interview.

“If someone has some responsibility on their shoulders, a job to get to and they need a good night’s sleep,” they are more likely “to commit to the program and put some energy into it,” and it works amazingly well.

“But, it’s harder for someone on disability who doesn’t really need to get to work. It’s harder for them to (get the motivation) to do the program,” the UCSD psychiatrist added.

“There are some things that people like (drinking and smoking) and it’s harder for them to give it up.”

Even though it ruins their sleep, they continue to drink and smoke. Ultimately both will disturb their sleep in the wee hours of the morning.

This program to cure insomnia may turn your life (and habits) upside down, but it can be like a ride on a huge, high roller coaster, and that can be exciting!

Contact writer Leo E. Laurence at (619) 757-4909 or leopowerhere@msn.com

Photo caption:

With a hint of a smile, Victor Gersten, 22, sleeps soundly, free of insomnia. Photo by Leo E. Laurence © 2010