Sleep banking helps you get some rest in advance

By Terry Ward, CNN

(CNN) — Dr. Diego Ramonfaur is often sleep-deprived.

In his third year of an internal medicine residency at the Cleveland Clinic in Ohio, Ramonfaur faces schedule changes every one or two weeks. With workloads that vary depending on the rotation, going to sleep and waking up at a consistent time is impossible.

So Ramonfaur, 30, turned to sleep banking — a strategy of getting extra sleep that some people use before a time when they know they’ll be sleep-deprived.

When Ramonfaur’s shifts are lighter but he knows longer rotations are coming, he will often try go to bed earlier to “gain a little bit of ground,” he said. ”Investing in sleep, even before I am tired, has been very rewarding in improving my performance during the shift and also with helping with overall burnout.”

The practice is part of his overall burnout prevention strategy during a busy time in life, and he said he hopes it will pay off a few years from now during even more intense cardiology training.

Healthy sleep is the ultimate goal

Experts agree that the recommended amount of sleep for adults is seven to nine hours per night, and going to sleep and waking at the same times every day — even on weekends — is optimal for a good night’s rest.

But what if real life gets in the way? That’s where sleep banking comes in.

Referred to as sleep extension in scientific literature, sleep banking is “the practice of implementing a really healthy sleep schedule and making time for ample sleep duration so that you can build up your resilience as you enter periods of insufficient sleep,” said Dr. Rebecca Robbins, a sleep scientist at Brigham and Women’s Hospital in Boston and an assistant professor at Harvard Medical School.

Sleep banking is only something she would recommend for those who have work schedules or other constraints that limit their ability to sleep.

This category includes medical doctors and members of the military with mission critical assignments leaving them limited time to sleep. Robbins said sleep banking has been used to keep them as healthy as possible during difficult times.

The practice may benefit other people with compromised sleep patterns, she said, including students before exams and professionals approaching a busy stretch at work.

What sleep banking can do

If you need an alarm clock or other assistance to wake up, you’re probably not getting enough sleep, said Dr. Yo-El Ju, a sleep physician scientist and professor of neurology at WashU Medicine in St. Louis.

Many people who are sleep-deprived probably have gotten used to it. “Most of us use alarm clocks to wake up,” Ju said. “I do, too. It’s not a moral failing.”

But the term sleep banking is a bit of a misnomer, she said.

“You can’t really bank sleep, but you can pay off the debt,” she said. It’s similar to using a credit card in that you pay off the balance of sleep debt a little bit so that you can spend more or stay awake longer.

When people know they won’t get enough sleep later on, they can make an effort to sleep more on the nights leading up to that period, Ju said. That starts to pay off the upcoming debt at just a day or two ahead of time but try at least a week (before the deprivation) for even better results.

“Getting up at the same time every day is also really healthy for our circadian rhythms. So ideally, you’d be waking up at the same time every day, but allowing yourself to go to bed earlier to get more sleep time,” said Ju, whose website provides science-backed help for better sleep.

If you want to try sleep banking for a period, begin your bedtime routine earlier and try to fall asleep 15 minutes earlier each night before a period of sleep deprivation, Robbins said. That’s so you’re slowly adding about an hour and a half every week of extra time you could spend sleeping.

Sleep banking can’t help you juggle

While studies show that sleep banking can improve cognition and recognition related to vigilant attention when it comes to things such as spotting a stimulus (like a light) and responding to it quickly and without mistakes, the practice has not been proven to help with executive functioning tasks, Ju said.

Skills that you use to manage everyday tasks, executive functioning is critical for safety and important for most people’s daily lives, Ju said, as well as for the ability to function at work. An example in day-to-day life is driving, when you might be forced to look in the rearview mirror for people cutting you off while at the same time answering questions from your kids in the back seat.

Sleep banking should also be avoided by those who struggle with insomnia, Ju said, since lying awake in bed for long periods doesn’t treat your inability to sleep and can lead to even more frustration.

Don’t do it all the time

For people with relatively healthy sleep patterns, sleep banking can help weather an upcoming schedule with reduced sleep, Robbins said. But once you’re through that time, it’s important to return to a normal sleep schedule as soon as possible, she said.

When you’re back on track, consider setting a sleep alarm about an hour or two before bedtime, said Ju, who likes a reminder to turn down the lights and get off screens.

“We’re so busy in our day-to-day lives that we just go, go, go, go, go — and then we crash in bed and expect to fall asleep,” she said. “And most of us cannot do that. Our brains need a little bit of a wind-down before we can relax and fall asleep.”

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