Stephanie Romiszewski — Sleep physiologist who worked with NASA and Harvard Medical School; treats insomnia and sleep disorders using cognitive behavioral therapy for insomnia (CBT-I).
The gist
Stephanie Romiszewski argues that society has become dangerously obsessed with perfect sleep, and that the anxiety and fear around poor sleep is what perpetuates most long-term insomnia rather than the original trigger. She debunks common myths: the rigid need for exactly 8 hours, the simplistic notion of sleep debt, fixed bedtimes, lying in to compensate, and the value of the snooze button. Her core method, CBT-I, uses sleep restriction (limiting time in bed) to rebuild a strong sleep drive, paired with re-education and mindset work. She stresses you can never force yourself to sleep but you can dictate when you don't, and that the wake-up time matters more than bedtime. The biggest fix is to worry less and treat sleep as one pillar of health rather than blaming it for everything.
Big reveals
- The fear of bad things happening from poor sleep is what she actually treats, not catastrophic illness from sleeplessness.
- Dictating an exact bedtime every night is, in her view, the worst sleep advice and can worsen insomnia.
- You do not need exactly 7-8 hours every night; think over a month, with consistency about 80% of the time.
- CBT-I deprives people of sleep opportunity (restricting time in bed), not sleep itself, to rebuild sleep drive.
- Treating insomnia separately from depression reduces relapse of depression because sleep is a perpetuating factor.
- Undergraduate medical degrees teach a median of only about an hour and a half on sleep.
- She spends most of her time not teaching people to sleep but resolving the mindset and fear around it.
Things worth remembering
- Science still does not know exactly why we sleep, only what happens when we don't.
- We are not made to think rationally in the middle of the night, which makes nighttime wakefulness feel lonely and anxious.
- The body can recover from sleep deprivation by increasing the specific sleep stage it missed most, rather than reclaiming hours one-for-one.
- Fatigue and sleepiness are different; sleepiness is specifically being able to shut your eyes and fall asleep within minutes.
- Research shows the snooze button provides no benefit; you cannot reach a beneficial sleep phase in those short windows.
- Caffeine sensitivity is genetic, so no universal cutoff time applies to everyone.
- We remember dreams mainly when interrupted out of REM sleep, a light and very active stage of sleep.
- Eating late forces the body to both metabolize and sleep, and it dislikes doing both, compromising one.
- So-called oversleeping is usually a sign of poor-quality sleep, sometimes from a disorder like sleep apnea.
- About 10% of insomniacs are never seen by clinicians because they simply don't perceive their pattern as a problem.