“This book is meant to be read like a sweeping novel. It is not a reference book. I do not want you to skip ahead to the part of the book that you think is most important for you. It’s all important! – Chris Winter

Thomas Carlyle once asked: “Does the boxer hit better for knowing that he has a flexor longus and a flexor brevis?” That is, while scientific knowledge is necessary to science itself, is the understanding of this knowledge worth more than a bit of trivia to someone developing a relevant skill or ability? And to what extent is physiological and biomechanical knowledge useful to an athlete vis-à-vis the development of his competitive prowess? Does knowledge truly improve his athletic intuition, or is it largely unnecessary to the development of the skill?

I make this point to address one of the fundamental woes of people attempting to improve their sleeping habits: to what extent does scientific knowledge of sleep affect the layman’s ability to sleep well? The public at large may have a passing idea of the importance of the known science of sleep – there are stages like REM and NREM, we all have something called a circadian rhythm, sleep is good for our health – and so on. Yet if we want to improve our ability to sleep – for sleep can be properly understood to be a skill – can we practically utilize these facts? Or do we require the consultation of other schools of thought – namely, psychology – to translate this information into something practical? To utilize the scientific and psychological foundations towards improving the skill of sleep, we can turn to Chris Winter, who succeeds in providing the best of both worlds in The Sleep Solution.

The Sleep Solution was published in 2017 by Chris Winter, a sleep specialist who is board-certified in both neurology and sleep medicine. It is an interesting book. There are many great and uncommon insights throughout the work and the author may largely succeed at re-inventing the way most people think about sleep for the better. Unfortunately, he occasionally leans too heavily into what it means to write a ‘layman’s’ book, and while he does have an excellent sense of humor, his style can mar the making of a great point and argument. Winter takes a bit too long to hit his stride, but when he does, he largely triumphs at his intention at providing a “solution” to most woes, and his intelligent application of the principles of Cognitive Behavioral Therapy in the fight against insomnia earns the work its right to be titled so.

The solution itself is both the forest and the trees. It is the book itself, the sum of its parts, but the different parts have different sizes and values – and some certainly stand out as flashes of brilliant reasoning over the rest. The work is divided into two parts and features a literal intermission chapter, and while the purposes of the first and second half cross over into one another, they are largely distinct. The first half is primarily concerned with communicating the scientific foundations of sleep, while the second half represents the bulk of solutions.

Winter sets the crucial scientific foundations in his early chapters. Within the first chapter, titled “What is Sleep Good For? Absolutely Everything!”, he details the relationship between sleep and: the brain’s function, obesity, blood pressure, mood, cancer, and the overall immune system. He continues part one to break down the primary drives of the body, the stages of sleep and the circadian rhythm. He also provides a chapter to make an interesting distinction between sleepiness and fatigue, emphasizing that these are distinct terms, but people often mistakenly use them interchangeably. My intention is not to gloss over these vitally important foundations, for Winter does present various solutions within these early chapters – but these foundations are largely common knowledge – and while they are necessary points, they are not the point of the book.

To start the second half, the author places particular emphasis on common-but-crucial bits of sleep advice to make a point: if you are not respecting these facts, further advice is unlikely to do you any good. In the chapter Sleep Hygiene, he focuses on knowledge that would be familiar to anyone who searched for sleep advice in the past. You ought to keep your bedroom dark and respect the bed as the ‘landing’ for the end of a day. Avoid the light from electronics. Exercise in the “melatonin suppressing sun.” If you must eat near bedtime, then eat foods with tryptophan, melatonin, or those with a high-glycemic index. Be wary of your vices. Nicotine and caffeine are stimulants and should be avoided in the hours before your bedtime, albeit by now you know to avoid the former regardless of circumstance. His points on alcohol are particularly interesting, as while many people consider it a positive sleep aid, Winter counters by clarifying the distinction between sedation and sleep. Alcohol is a sedative, but being sedated does not necessarily translate to good sleep, as Winter points out: “… what’s not disputed is the mess alcohol makes of the second half of your night as the alcohol is metabolized. Ever wake up about four to six hours after a binge and find it absolutely impossible to go back to sleep? It’s like an amazing Caribbean cruise that ends with your boat sinking. Is there anything in the first half of the cruise that could compensate for the soggy ending?” Alcohol may have calmed you and aided in letting consciousness wane, but that is not the same thing as a good night’s rest. 

While I have said the solution is largely the entirety of the work, its major theses come out in the chapters Insomnia and Hard Insomnia. His approach is largely to assist you in thinking as clearly as possible at sleep. After some insightful deconstruction of the concept of insomnia, Winter concludes with the following definition: “Insomnia is not when an individual can’t sleep. The true definition of insomnia consists of two components: 1. A person is not sleeping when she wants to sleep. 2. The person cares, and usually cares a lot, about not sleeping, whether or not she wants to admit it.”

He chooses the words “can’t sleep” to make a point that recurs throughout the book, with this quotation appearing in the second chapter: “They [insomnia patients] are sleeping; they just don’t perceive their sleep effectively. In other words, their assertion of not sleeping is just plain wrong. The medical fact is, we all sleep. It’s a primary drive. The body insists on it. So the first thing I need to tell you if you are one of those people who “never sleep” is this: You need to accept one simple fact, or you will be doomed to struggle with your sleep forever. YOU SLEEP.” At first glance, this may feel like a petty, merely semantic hill to die on, but Winter is here utilizing Cognitive Behavioral Therapy to make a point that is anything but petty.    

Anxiety is overwhelmingly cited as the most common cause of insomnia, and one of the greatest tools psychologists have conceived to combat anxiety is Cognitive Behavioral Therapy (CBT), and Winter’s major solutions utilize this form of therapy. One of the main concerns of CBT is the nature of sentences we tell ourselves. This school of thought stresses that we often fail to distinguish between truly innocent hyperbole and the unhealthy, exaggerated sentences we tell ourselves. Albert Ellis, one of the pioneers of CBT, refers to these latter sorts of statements as “catastrophizing.” Instead of recognizing of something as “unfortunate,” it is “awful.” Instead of recognizing something as “difficult,” we say it is “impossible.” These latter terms are far more anxiety-inducing than their former counterparts – and this is the crux of Winter’s point. When he wants you to stop saying you “can’t sleep” and to understand “you sleep,” he is gravitating the reader to a far less catastrophizing idea. He points out that patients refer to their insomnia as “terrifying,” that they feel “helpless.” This is why, psychologically, it is crucial to understand that you do sleep.

In the second part of the definition, “The person cares, and usually cares a lot, about not sleeping…,” he is referring to the unfortunate, anxiety-ridden cycle people get themselves into about sleep. They have put so much mental pressure on themselves to sleep that they are unable to fall asleep easily, worrying “…their productivity will suffer at work or they will feel exceedingly bad during the day. Their anxiety about the consequences of not sleeping ratchets up to fear…” He counters this by arguing “bad sleep is much more dangerous in your mind than it is in real life.” Occasionally getting insufficient sleep is an inevitability of life – but obsessing over these nights and believing you were dysfunctional because of poor sleep is what leads to these vicious cycles of restless nights. Regarding what patients irrationally think about sleep, Winter says: ‘“When I don’t sleep, I can’t function.” Cognitive therapy would say, “You woke up, you taught your third-grade class, you went grocery shopping afterward, and while you didn’t make it to the gym, your day was not dysfunctional.”

Winter differentiates between simple insomnia and hard insomnia. Simple insomnia is so named to “…reinforce the idea that it’s just that. Simple. Harmless even. Most likely the cause is staring you in the face. I put this section in the book so people who develop simple insomnia can learn to recognize it early and nip it in the bud before it becomes hard insomnia and more difficult to treat. Simple also implies optimism.” Hard insomnia, however, is far more difficult to wrangle with. Hard insomnia comes about after dealing with sleep issues for many months on end, wherein poor sleep and insomnia have become part of the patients psyche and identity. “I’m not saying that they are traumatized because they aren’t sleeping. What I’m saying is that the presence of hard insomnia for years and years is itself traumatizing.” These patients are so damaged that they fail to be objective about the reality of their sleep, which leads Winter to make a distinction between sleep identity and sleep quality – the necessary implication being that these do not always align, and this misalignment is a primary characteristic of hard insomnia patients. He summarizes this problem: “To feel poorly, you don’t have to sleep poorly (or sleep too little); you just have to believe you do. This too was seen in studies. Good sleepers with high distress functioned more poorly than good sleepers with low distress. No surprise there. What was surprising was the high-distress poor sleepers functioned similarly to the high-distress good sleepers. This seems to give some insight into the “dysfunction” seen in some insomnia patients. The dysfunction is more tied to the patient’s view of her sleep quality (and the resulting stress over it) than it is to her actual sleep!”

His conclusion is to largely condition yourself to care less about sleep: “When you talk with good sleepers, they all have a flip-flops-and-Hacky-Sack mentality toward their sleep. “Whatever, dude.” Within them is an inner belief that they are basically going to be okay no matter what happens that night in bed. This is the mentality you must find, or you will be doomed to struggle forever.” There are far more solutions contained within the book than I have communicated, but Winter will frequently stress that it is absolutely worth consulting a professional if (and especially if) the book was unable to resolve the reader’s woes. While insomnia as anxiety is the most frequent cause of sleep disturbances, Winter does his diligence to make the work definitive. His concluding chapters discuss sleeping aids and medications, sleep schedules, naps and the medical (as opposed to psychological) conditions that can incite sleeping problems.

I have not said much of his style, but it is worth concluding with as it is one of the most distinctive qualities of the book. Winter is eventually charming, often downright hilarious, but his sense of humor occasionally interferes with the making of a point. “All of this talk of poor sleep, heart failure, Alzheimer’s disease, and not fitting into your favorite jeans is a super downer. Want something to help brighten your mood? Try sleeping. Seriously.” Amusing enough, but this quotation from the first chapter appears before any inkling of a solution is offered – that is, the reader is first introduced to Chris Winter, the comic, long before they meet Chris Winter, the insightful sleep researcher. If he wants his early quirkiness to be tolerated because of his credentials alone, he should remember how many doctors with similar credentials he dismisses throughout the book. Yes, the chapter is detailing various studies on why sleep is so important, but for the first half of the book Winter struggles to elevate himself above someone merely with access to Wikipedia. In Insomnia he writes: “But bad sleep is much more dangerous in your mind than it is in real life.” Then why are these mortal conditions associated with poor sleep, such as cancer, detailed in the beginning? It would not be so hard to do away with this contradiction, either by eliminating the sentence or by qualifying this statement further, but Winter fails to address this Gordian Knot and leaves it largely untouched. So too have I framed his early Cognitive Behavioral Therapy points better than he did, and his introduction of those points does read like a petty semantic battle. If this book undergoes a second edition, which it arguably requires, Winter should restructure much of what appears prior to the intermission. Do not misinterpret my meaning here – Winter does have a brilliant sense of humor. I would not suggest he “tone it down,” but rather be more critical of when to joke and when to communicate clearly. The Sleep Solution has the potential to be an icon of the self-improvement genre, these sloppy weaknesses hold it back.

Despite the preceding paragraph, I nevertheless recommend reading it. Winter has taken a profound approach to the subject and makes the bold decision of embracing uncomfortable truths. As anxiety is overwhelmingly the number one cause of recurring sleep issues, it is the patient’s or reader’s identity that must be coerced to change if their sleep is to improve. The book will likely succeed improving the sleeping habits of every reader to some degree, and where it may fail it nevertheless informs as to how to think more clearly about sleep in general. As per the recommendation of the author himself – if the methods and points made in The Sleep Solution are not enough to get you on the right track, it is likely time to consult a specialist in person.