ABSTRACT
THE DEVELOPMENT OF SLEEP RESTRICTION THERAPY The practical and theoretical roots underlying the development of sleep restriction therapy (SRT) in 1987 (1) are readily traced: foremost, two decades of research into the physiological and cognitive consequences of sleep deprivation under various paradigms had led to solid findings regarding the effects of deprivation or restriction on sleep itself. These findings suggested that disturbed sleep might in some instances benefit from restricted bedtime. Second, psychological theories of the genesis and persistence of emotional distress provided a framework for understanding how attitudes and anxieties about sleep might harden into chronic insomnia. This work suggested that an intervention able to break the vicious cycle of anticipatory anxiety leading to sleeplessness leading to increased anticipatory anxiety could be of great benefit even if it could only be tolerated in the short term. Third, the new field of chronobiology was burgeoning, and its findings beginning to find clinical application. There was much greater appreciation of how the timing of bedtime affects the ability to fall and stay asleep. Finally, while pharmacologic treatment for insomnia with benzodiazepines and other medications was gaining wide acceptance, pitfalls and inadequacies associated with such treatment were becoming apparent, fueling the search for effective behavioral interventions.
