How Anna went from not feeling sleepy at night and thinking her sleep system was broken to sleeping well and with confidence (#17)

Transcript

Martin Reed:
Welcome to the Insomnia Coach Podcast. My name is Martin Reed. I believe that nobody needs to live with chronic insomnia and that evidence-based cognitive and behavioral techniques can help you enjoy better sleep for the rest of your life.

Martin Reed:
The content of this podcast is provided for informational and educational purposes only. It is not medical advice and is not intended to diagnose, treat, cure, or prevent any disease, disorder, or medical condition. It should never replace any advice given to you by your physician or any other licensed healthcare provider. Insomnia Coach LLC offers coaching services only and does not provide therapy, counseling, medical advice, or medical treatment. The statements and opinions expressed by guests are their own and are not necessarily endorsed by Insomnia Coach LLC. All content is provided “as is” and without warranties, either express or implied.

Martin Reed:
So, Anna, thank you so much for taking the time out of your day to come onto the podcast.

Anna Wojcicka:
Thank you for having me.

Martin Reed:
So can you get us started right at the beginning? When did your problems with sleep begin and what do you think caused you initial issues with sleep?

Anna Wojcicka:
Sure. So in general, I have never been a very sound sleeper. I was never a person that took naps. I never really enjoyed sleeping in. So I think in general I always needed less sleep than an average person, but it was never really a big problem and I was actually quite happy with it. I started having short episodes of insomnia I would say maybe around five years ago. They would be triggered by something like a work-related stressful event and then I would have trouble falling asleep for maybe a week at a time or two weeks and then it would generally resolve itself on its own.

Anna Wojcicka:
Two years ago I had a stressful event that was health-related. So my mom was having some heart issues and we didn’t know exactly what was wrong with her. It lasted for quite a while and then doctors were running some tests, she needed to have a surgery. So the whole situation I would say lasted for maybe six week or so, and during that time period I was having a hard time sleeping. I think this is when my real sleep problems actually started. So before, like I said, within a week or two insomnia would resolve in its own but this time, I think because of how long it lasted and also because of the fact that I turned to sleeping pills a little bit during that time period even after the stressful situation resolved and everything went back to normal, and it was basically the best possible outcome. So my mom’s heart was fine, I was stuck on my sleep problem. So I was still not able to fall asleep at night.

Martin Reed:
Yeah, I think you just touched upon it there. Was the main issue just falling asleep at the start of the night or was it also some kind of struggle with waking during the night and finding it hard to fall asleep.

Anna Wojcicka:
Yeah, that’s right. So I know there are different types of insomnia, right? Some people have problems waking up in the middle of the night and some people have problems waking up too early. For me it was always falling asleep. So sleep-onset insomnia. And I would say some nights I would also have issues with waking up during the night, but it was always mainly, the main problem for me was falling asleep.

Martin Reed:
Yeah, I think a lot of people are going to identify with your experience. So many people that struggle with chronic insomnia can actually identify with that idea that, “Well, I’ve never been a good sleeper. For as long as I can remember I’ve always experienced sleep disruption from time to time, but then something happened at that was the time when my sleep just didn’t recover by itself.” That’s actually really common in people with insomnia and fits this model that we actually have for chronic insomnia, this there P model whereby the first P is predisposed. Some people are just more predisposed to sleep disruption.

Martin Reed:
Then we have the second P which is a precipitating factor which is whatever that event was that triggered the sleep disruption, and then normally once that issue is no longer relevant sleep recovers. But sometimes there’s that third P which are these perpetuating factors and this is what makes it hard for our sleep to recover and typically these occur when the way we think about sleep changes, we start to worry about sleep. If we’re used to, for example, just going through these bad patches that last a few days and then suddenly they become a few weeks we start to really worry. We start to do all that research about sleep, different experiments, we change our behaviors. We might start going to bed earlier, trying to nap during the day when we never used to do that. Staying in bed later. Maybe calling in sick to work, canceling plans, trying to conserve energy. All those things that we quite understandably do in a bid to improve our sleep but actually perpetuate the problem. When it comes to those perpetuating factors, I see you’ve got that smile on your face. Can you identify with any of them?

Anna Wojcicka:
Of course, yeah, I can 100% identify with many of the things you just mentioned. I think one for me that stood out and because I actually have a lot tendency to overanalyze, I was researching sleep. So that was my main task of the day. I would go to work and then I would go on insomnia related forums on the internet, or I would look at YouTube videos, or I would read articles, or I would research how harmful insomnia could be, or the harmful effects of sleeping pills, or how you could improve sleep latency. I basically became an expert and I was thinking about sleep constantly, and as you can imagine, that didn’t help because basically that was only fueling my worry.

Anna Wojcicka:
And truly enough I also, you know, I changed behaviors. I tried going to bed early. I tried all of the different supplements. I tried different relaxation techniques. So, yeah, so I think as you mentioned, this is where the self-perpetuating cycle of the thought and the thought patterns that began to change and this is where the chronic element of my insomnia set in.

Martin Reed:
Yeah, everything that you did is completely natural that we want to do that, right? If there’s a problem we want to try and solve it so we … For most of us, that means just going online and looking for some information and advice. The problem with insomnia is so much of the messaging that’s out there and the information out there just really is not helpful and can actually lead to even more sleep-related worry. I think you just touched upon it where you’re seeing all these articles that say, “OH, if you don’t get X amount of sleep this is going to happen. If you take sleeping pills this is going to happen.” Everything out there, all the messaging around insomnia just is very alarmist in nature and makes you tend to worry about it more.

Anna Wojcicka:
I agree that a lot of the messaging out there is focused on people who don’t prioritize sleep.

Martin Reed:
Yes.

Anna Wojcicka:
And paradoxically people who are looking at this content and researching things related to sleep are people who can sleep, right? So the target audience is a little bit off and I feel like for people who are struggling with sleep, warning them about the dangers of not sleeping is definitely not what they need to see.

Martin Reed:
Yeah, I 100% agree with you. A lot of the messaging out there might be helpful for people that are just burning the candle at both ends and just not paying attention to sleep, and as a result they’re deliberately depriving themselves of sleep. But the issue is, is those people aren’t reading these messages. The people that are reading these messages are the people with insomnia that are struggling with sleep, and so much of the scare tactics that are being used just make insomnia even worse. And experience when it comes to things about these articles that claim insomnia causes certain health conditions, there’s actually no evidence whatsoever that insomnia causes any health problem whatsoever. We see some studies that make associations but the actual cause could be any number of things. Even to this day, we have no evidence of that and there was this huge study that involved tens of millions of people that were … And they looked at people with insomnia and people without insomnia and tried to assess mortality risk. You know, does insomnia increase your risk of death? No difference whatsoever. It was exactly the same in the insomnia group and the non-insomnia group.

Martin Reed:
So the problem is, is when we go online and we see this messaging it’s very rarely helpful because it just makes us worry about sleep even more, and as you said it just perpetuates the problem.

Anna Wojcicka:
Right. So it’s difficult for a person who’s not familiar maybe with the scientific articles or with going in-depth and doing your own research to distill the facts versus and article that someone has just written and is claiming something that is not supported by evidence.

Martin Reed:
Yeah, exactly. So in a way, we have to rely on journalism to pick these very dry studies apart, but unfortunately, their motivation is to get attention. They’re not going to get attention if they say, “Insomnia, it kind of sucks but it doesn’t cause a health problem.” That’s not going to get attention but if they can come up with some grandiose claims, you know, interpreting the study in a certain way and emphasizing very small parts of the study then they can get their attention. So, yeah., it is a problem.

Martin Reed:
But you kind of touched upon these scientific-based techniques, evidence. As you know, as I know, as people that listen to this podcast know these cognitive and behavioral techniques, they’re evidence-based. We know from experience, from study, there’s so much clinical evidence that they work. Before you discovered them though, what kind of things did you already try to do in a bid to improve your sleep?

Anna Wojcicka:
Right, so I knew that this question was probably coming. So I actually, I wrote down some things because I did so many things in the year and a half that I was struggling with really bad insomnia that I would probably forget. So starting with, Of course, cutting out caffeine. So I went from drinking maybe two to three cups of coffee a day to first only limiting it to one, and then not drinking any coffee and then also cutting out tea and any caffeinated beverages which made no difference whatsoever.

Anna Wojcicka:
I installed blackout blinds in my bedroom, which is I guess nice to have right now, right? But when I was suffering from insomnia it didn’t make any difference at all. I tried different supplements. So you name it, I tried it. I tried melatonin, magnesium, valerian root. 5-HTP, L-theanine, CBD oil, all of these kinds of things. I tried different light-related tricks. So I got these orange glasses, a blue light blocking glasses which are supposed to essentially block out all of the blue light from the environment and I was wearing them for two to three hours before bed. I had glasses that were emitting blue/green light that I would put on in the morning. They were supposed to stunt melatonin production and similarly help to produce more melatonin the following night.

Anna Wojcicka:
I was using all kinds of different sound machines. I put a fan in my bedroom to make that is was kept cool. I got a gravity blanket, which is essentially a weighted blanket. It’s I think used with some psychiatric conditions to help people calm down. So I was just using it as a cover when I was sleeping. Then, of course, I tried alcohol. I tried smoking marijuana. I tried all of the different conventional things that people also used to help themselves fall asleep.

Anna Wojcicka:
The list goes on. I would say some of these things helped for a little while, and some of the things may have improved my sleep quality or the length of my sleep marginally or they did in the beginning and they stopped working. Sometimes it was perhaps placebo that helped me a little bit, but none of the help they provided was persistent and I feel like the more I did the more I focused on sleep, which was fueling this vicious cycle of thoughts. I was basically always researching the next thing that I was going to do to see what I could do to improve my sleep.

Martin Reed:
Yeah. That’s exactly the point I wanted to make and you made it for me is we try all these things, quite understandably. They might seem to help at first, probably because we’re expecting to help, you know, or we’re convinced that they’re going to help so this first few nights maybe we notice some improvement but then because they’re not actually really helping we go back to square on. But the problem is, then we become worried because this new thing didn’t work so then we have to look for something new, and then when that doesn’t work then we have to look for something new. And the whole time we’re on this journey we just get more worried about sleep and think more about sleep. That seems to me like that’s what you were saying. You try all these things, all it led to was more worry and more obsession about sleep. Does that sound about right?

Anna Wojcicka:
Yeah. So I felt by the time I actually turned to CBT-I I feel like I had tried literally anything and everything under the sun. There was nothing else I could’ve tried to help my insomnia.

Martin Reed:
Yeah. So what was it that made you … First of all, how did you find about these cognitive and behavioral techniques and what gave you the motivation to give them a try because after all, you tried so many things before and when people with chronic insomnia hear of another thing by this point they’re very skeptical. Like, “I’ve heard this story before. Yep. People tell me this works, people tell me that works but it doesn’t work.” So how did you find out about these techniques and what gave you that motivation to get started and give them a try?

Anna Wojcicka:
Sure. So I actually came across cognitive behavioral therapy for insomnia approach relatively early on in my research. So maybe I was suffering with insomnia for four or five months, and then I came across this technique that was based on restricting your sleep even further and then leaving your bed when you are not falling asleep within five or 10 minutes. And to be honest, it just sounded really bad and I didn’t give it a second thought. But I kept it in the back of my mind always and after I felt like I have tried everything else, I felt like it was the last resort. Either I tried this and it worked or I would be stuck with insomnia for the rest of my life so I had nothing to lose. It sounded horrible but my life was already horrible as it was so it didn’t really hurt to try it.

Martin Reed:
Yeah. You made a really good point that a lot of these techniques do seem really counterintuitive, because your goal at the end of the day is to get more sleep. So one of the techniques, sleep restriction, which is a terrible name because it implies we’re restricting sleep but what we’re really doing is just restricting the amount of time you allot for sleep. Because people with insomnia, they often spend a lot of time in bed in a bid to try and get more sleep but more time in bed doesn’t mean time asleep, it just means more time awake and more time awake just means more time worrying, more time tossing and turning. Unpleasant, right?

Martin Reed:
So what we say is, “Well, how much sleep do you think you get on an average night?” Let’s say it’s four, five hours. Maybe add half an hour or an hour to that and then only allow yourself to spend that much time in bed. Only allot that much time for sleep. This way you’re spending less time awake during the night and because you’re allotting less time for sleep you’re giving enough time for sleep drive to build during the day. So you’re going to be sleepy enough for sleep when you go to bed, because that’s another thing that many people with chronic insomnia do is they’ll go to bed before they’re sleepy enough for sleep and then get frustrated when they’re not falling asleep, and I think one reason why is because it’s really easy to confuse fatigue with sleepiness.

Martin Reed:
So we can feel really worn out and fatigued and think that that’s sleepiness, which is a very common misperception. Even people that don’t have any sleep issues often confuse fatigue with sleepiness. Then we go to bed and quite rightly we’re not falling asleep but then we become convinced that, you know, “I’m not falling asleep. It’s because of the insomnia. There’s something wrong with me.” When what’s happening is completely normal. So that’s the restriction in a nutshell, which is building sleep drive, reducing the amount of time awake during the night. And then the other technique you touched upon. The idea of getting out of bed, that’s helpful if we’ve learned that the bed is an unpleasant place to be. So more to do with we wake during the night and our mind just goes into overdrive, we get really worried by the fact that we’ve woken up and we’re really struggling to fall back to sleep. It’s often a good idea to just get out of bed. Just do anything that you find relaxing and enjoyable until you feel calm again and then return to bed.

Martin Reed:
And again, it seems counterintuitive because you’re thinking, “I want to get to sleep. How is getting out of bed going to help me?” Well, if you’re in bed awake tossing and turning and not asleep anyways you might as well get out of bed, distract your mind and not allow yourself to reinforce that idea that the bed is an unpleasant place to be. So, yeah, I thought it was a really good insight that you share with us that a lot of people that maybe have explored these CBT-I techniques before have thought, But this sounds completely counterintuitive.” So I appreciate you gave me the opportunity to just touch upon a couple of those techniques and justify the rationale behind them.

Anna Wojcicka:
Yeah, definitely. So, as you said, some of these things sound really counterintuitive, but for example, the getting out of bed really changed my relationship with my bed. I remember that when I was suffering from insomnia I would get terrible anxiety when the bedtime was coming and I would feel my body tense up, and I would feel like I was breathing faster and my whole body was tense when I was getting into bed. Now, it’s completely different. I feel more relaxed. I’m associating my bed with rest and with sleep, and it actually helps me fall asleep when I’m in my bed. Before I tried this approach I was able to fall asleep on the couch much easier than in my bed. Bed was the last place where I would ever fall asleep.

Martin Reed:
Yeah, and that is a classic symptom of that conditioned arousal. So just because we’ve learned that the bed is this place where we’re going to have a horrible night, we’re going to be wide awake, tossing and turning. Often in the short-term if we say, “Well, I’m going to go sleep on the couch then.” Then because you don’t have that mental association between the couch and wakefulness, and frustration, and anxiety you can find it easy to fall asleep on the couch, but that really isn’t a long-term solution unless your goal is to sleep on the couch for the rest of your life, you know?

Anna Wojcicka:
Right.

Martin Reed:
Really what we need to do is rebuild that association between the bed and sleep, you know. Make you think of the bed as a pleasant place to be just like it was in the past, but unfortunately the only we can do that is by making sure that you’re only in bed when you’re calm, relaxed, or asleep. You know and every single minute that you spend in bed when you are calm, relaxed, or asleep you’re rebuilding that association to make the bed a strong trigger for sleep again.

Martin Reed:
Okay. So that’s good, so I think it was around, this was back in around October, middle of October time you started with sleep restriction. Do you remember how much time you were allotting for sleep before you tried this and how much time you changed this to be allotting for sleep?

Anna Wojcicka:
Sure. So usually I have to wake up around eight AM to go to work and, of course, I was aiming for the perfect eight hours of sleep so I would go to bed around midnight, maybe 11:30. Then surely enough I would toss and turn for hours and maybe then fall asleep around two or three AM. So that was before I tried sleep restriction. When I started applying a restricted sleep window I went for six hours. So I would go to bed at two Am and I would aim to wake up at eight AM.

Martin Reed:
Yeah, that’s really common, you know that … Because we’ve got all this messaging that we need eight hours of sleep so many of us therefore allot eight hours of sleep because we allot the amount of time for sleep that we want to be getting that amount of sleep, right?

Anna Wojcicka:
Right.

Martin Reed:
So it makes sense that a lot of people with insomnia I do find that when I start working with them they’re allotting around about eight hours, sometimes even more time for sleep and it’s just not helpful. We want to allot the amount of time for sleep so it’s similar to the sleep you’re currently getting, and then once you start to get results, once you start feeling that sleep windows is sleep, you’re not going to be restricting your sleep window forever. This is just to get you started and once you start filling up that sleep window with sleep, that’s when you can start gradually extending it out and just see what kind of overall sleep duration you’re capable of sustaining over the longer-term.

Anna Wojcicka:
Yeah, I would I guess like to say that if someone is struggling with falling asleep, so sleep-onset insomnia, this can be particularly hard because not being able to fall asleep for three or four hours when your sleep window is only six hours really doesn’t sound appealing at all. I felt like, “Okay, I will go to sleep around 11. I need to wake up at eight AM. Maybe I will fall asleep after three or four hours and maybe I will get the five hours, and maybe I will function somehow. But I’m definitely not going to be able to function if I get one hour or two hours.” Right?

Anna Wojcicka:
So it sounded really frightening because I was really convinced that this is what essentially this is going to lead to. I was only going to get one or two hours of sleep every night. And surely enough this is how it started, right?

Martin Reed:
Yeah, I was going to ask you about that because I remember I think you were a week and a half in and you got really concerned because you felt that things were actually getting worse. That your sleep was getting worse. It wasn’t getting better. So can you tell us a little bit more about that?

Anna Wojcicka:
Yeah, sure. So the first week of sleep restriction I felt like I made some progress. So I was positively surprised. I was quite sleepy when my sleep window was starting. I would maybe fall asleep within half an hour to an hour. I was pleased. But then something happened, I think I had one bad night and that made me anxious. I started thinking, “Okay, maybe this is not working for me.” Of course, it doesn’t work for 100% of the people who try it, right? So I’m probably one of those and it’s not going to work for me and then this anxiety-fueled another bad night, and another one and then, yeah. I think I had a little setback in week two, but then I think my sleep drive won. So later even though I was still nervous and I was still getting anxious before bed I started sleeping more deeply and more consistently. And I think when I really started seeing consistent improvement was in week four. Then I would say I would regularly fall asleep within 10 to 15 minutes, and I would sleep during the whole sleep window that I was allotting for sleep.

Martin Reed:
Yeah, you made a really important point there that your sleep drive won. Your sleep drive got to that point where you did sleep and that’s something really important to bear in mind is that sleep drive does always win in the end, you know? So there may be blips, ups and downs along the way, completely normal. When you experience a few bad nights, ultimately that’s okay, because what happens from night to night isn’t that important because you’re looking to make these long-term improvements. So what happens from night to night doesn’t matter all that much, if you stay consistent with the techniques sleep drive will always win in the end, you know? Because you can’t stay awake indefinitely and every hard night, every night of short sleep builds that sleep drive, builds that sleep pressure and makes sleep more likely the following night.

Anna Wojcicka:
It’s difficult to imagine for someone with insomnia. I know that it was true for me. I really didn’t think I had any sleep drive left. I didn’t remember ever feeling sleepy. I would maybe feel tired but I was never sleepy. I would go to bed and sometimes fall asleep but it was not this pleasant drowsy feeling that I was getting. It felt more like passing out that I was not really aware of. So I really felt like something was inherently broken with my sleep system, and from all the research that I did on the internet it didn’t seem like it was possible but I was convinced that I was the exception. My sleep drive, my sleep system didn’t work which was of course, it was not true. It was not the case.

Martin Reed:
Yeah, exactly. It’s so important to recognize that we never lose our ability to sleep. It’s something that is with us forever, but this … When we have a high level of worry or anxiety arousal around sleep we can definitely suppress those sleepiness cues and make sleep more difficult and that can lead us to believe that we’ve somehow lost our ability to sleep or there’s something uniquely wrong with us and that’s almost certainly never going to be the case. And it’s also really important to recognize that when you’re implementing these techniques it’s completely natural to be disheartened when you have setbacks because your sleep confidence is going to be really poor. You’re at that stage where let’s say you have that week of good sleep and you just start to get that little bit of confidence back, but then you maybe just have that one night where it’s a struggle again. And instead of thinking of those seven nights previously that were pretty good your brain just wants to focus on that one night, you know? Then all of that confidence you’ve been building it can so easily shatter. So I think it’s really important to make a conscious effort to focus your attention on all the good nights rather than just allowing your brain to naturally focus on the minority of nights or that one night that was really difficult.

Anna Wojcicka:
It’s really important to keep the big picture and it’s always easier to remember bad things than good things.

Martin Reed:
Yes.

Anna Wojcicka:
And it’s always easier to focus on something that happened yesterday versus something that was consistently happening for the past two weeks. So I feel like keeping a sleep diary really helped. I always kept the time that I went to bed. How long it took me to fall asleep. How many hours I spent asleep. How much time I was awake during the night, when I woke up and looking back on it and consistently across weeks I felt like I was able to get a big picture and not get discouraged by bad nights that were, of course, happening here and there once in a while.

Martin Reed:
Yeah, I think that that can be helpful. Just keeping some basic journaling of your sleep. On one hand, sometimes people can get a little bit too obsessed with it, and record it and then just spend a lot of time looking at it every single day running all these numbers and crunching it and stuff like that, which is not the intention. We’re just looking to track progress so if you log information about your sleep like you just described I try and encourage people just not pay much attention to what happens night to night, maybe at the end of a week or at the end of two weeks look at it just so you do get that bigger picture because otherwise it’s really easy. Let’s say you had a really good night, you kind of gloss over that, “Oh, yeah. Last night was great.” Then you go off have your breakfast, but then the next night maybe you only got two hours of sleep and you’re just sitting there thinking about, running all the numbers, “Why did I only get two hours sleep that night?” The brain kicks in and you’re just feeding that obsession with sleep, which is never helpful.

Anna Wojcicka:
So I 100% agree that it’s not useful to look in-depth into the data every day, and I had this problem. So I had a Fitbit which has a sleep tracker in it, and whenever I would wake up that was the first thing that I did. I would look at how I slept, how many hours of deep sleep I got, how it compared to what was expected. What helped me was looking at the big picture. So looking at, “Oh, how was my sleep this week? How did it compare to the previous week? How was my sleep efficiency in this given month?” But definitely not looking at sleep data day to day. I took off my Fitbit, I don’t wear it anymore and I don’t even want to be tempted. I know it’s tempting. Right now that I’m sleeping well I’m really tempted to put it back on again, but at the same time I’m scared and I also know that we shouldn’t be relying on tracker to tell us how rested we feel or how tired we feel, or how much we should be sleeping. We know it. I know now when I feel rested and I know when I feel tired, and I know when I feel sleepy and we should be relying on our body for these cues.

Martin Reed:
Yeah, I completely agree. If you’re getting through the day, you feel like you’ve got enough energy to get through the day, you’re having productive days then the chances are you’re sleeping fine regardless of how many hours you’re getting and no kind of tracking device can tell you if you personally are getting enough sleep because we all have our own individual unique sleep requirement. Some people might function perfectly fine on four or five hours of sleep. Other people might feel like they need nine or 10 hours. There’s a huge range and everyone is different. And, yeah, with those sleep tracking devices, especially for people with insomnia, they really can just heighten that anxiety, that arousal and just lead to those obsession over data that we’re still not 100% how accurate it is. Especially in people with insomnia. They tend to really struggle to determine between wakefulness and sleep.

Martin Reed:
But we can’t really do much with the information that it gives us, you know? Because you touched upon sleep stages. We can’t control how much time we spend in each sleep stage. Our body does that by itself. We can’t control how long it takes us to fall asleep. We can’t control how much time we’re going to be awake during the night. So all this data that we’re getting back from these devices, we can’t do anything with it. The only thing we can do with it is worry about it.

Anna Wojcicka:
Right, yeah. I remember countless times I tried to put together the behaviors that lead to more increased deeper sleep on a given night and then whenever I tried to replicate it just didn’t work. So I felt like it was completely useless. That data was not replicable and I was not able to consistently get the same results by implementing a certain behavior. So it could be that the tracking device which will be able to really tell us something true about our sleep is yet to come out, but yeah. I don’t think it’s available at this time.

Martin Reed:
Yeah, no I think perhaps they could be helpful if you’re one of these people that really as you get zero minutes of sleep. Like you’ve gone for let’s say two weeks and not even had one minute of sleep, which would be pretty much impossible but it’s very easy to believe that that’s the case. Then it might be helpful temporarily to use one just to get that relief because it will show that you are sleeping because it’s pretty much impossible to be awake for that long. Otherwise, I just find that they can really unhelpful and actually perpetuate the problem because they lead to this obsession with sleep.

Martin Reed:
So I just wanted to go back to that period when you were struggling during that sleep window. So many people would just be tempted to think, “Oh, this isn’t working. And just move onto something else. How did you get through that rough patch and just stay persistent, and consistent, and get through it and keep going?

Anna Wojcicka:
Right. So like I said, I tried everything else and this was my last resort. I was prepared to really give it a go and at some point I remember telling my boyfriend that I was going to give it six weeks. I was going to give it my best and if it didn’t work in six weeks then I would give up. Then I would accept the fact that I’m going to have insomnia for the rest of my life, or start taking heavy-duty sleeping pills every night. That was just what I was going to live with. But I was committed to really trying it and sticking to it for that specific set period of time.

Martin Reed:
I think that’s really helpful and I think six weeks is a pretty good period to give yourself and just set it and forget it. Engage that robot mind and just be, “No matter what, for six weeks I’m going to do it.” I think that’s a good enough timeframe to at least notice some consistent improvements in sleep. Some people I feel like don’t give it long enough. They might just say, “I’m going to give it two weeks or one week.” I think six weeks is an appropriate timeframe and that’s a good strategy because you don’t know unless you try, right?> and if you give yourself enough time you just focus exclusively on this one thing for six weeks. If it doesn’t work then you know it doesn’t work because you’ve given time, you’ve given it a good chance but it could work and after six weeks it almost certainly will work. I don’t think I know of anyone that’s implemented sleep restriction correctly and consistently for six weeks and not noticed improvements in their sleep. So that was a really good insight that you just shared there. I appreciate that.

Anna Wojcicka:
Yeah, I remember I was struggling to find information online regarding how long I should do it, and what is the average time that people start seeing improvements? And really there is no consistency out there and I know it varies from person to person, and everybody is different. But I think if people got a clear guideline that after six week or two months you’re definitely going to see some improvement they would know what to expect and they would know what they would need to stick to to definitely start seeing some improvement.

Martin Reed:
Yeah, that’s a good point. I think maybe the messaging needs to be improved just to help set realistic expectations. That these techniques do require a lot of effort, a lot of willpower, a lot of consistency and they do take time to work and there’s going to be ups and downs along the way. It’s not this miracle cure. It’s not like pop a pill and then suddenly you’re going to sleep. It’s something that does take effort and does take a little bit of time to work, but it’s worth it because once you recognize that it does work, that’s a skill that’s then with you for the rest of your life. So if sleep ever becomes a problem again you know exactly what to do. You just reach into your back pocket and just start implementing these techniques again.

Martin Reed:
So one thing I also wanted to touch upon was you said how if you’re already struggling to fall asleep, it’s taking you a couple of hours in those early days of sleep restriction when you’re going to be allotting less time for sleep you can get this worry that, “Well, now I’ve got even less time available for sleep. If it’s going to take me a couple of hours to fall asleep this means I’m only going to be getting maybe two or three hours of sleep and that can just trigger all this worry and anxiety.” How did you address that concern?

Anna Wojcicka:
I didn’t. I was worried and I was concerned. I realized though that when I was not taking sleeping pills I would generally feel better than I expected on the days that I got two to three hours of sleep. I felt like maybe my body was in a state of hyperarousal, I don’t know, but some days I felt completely fine and then I felt like that actually helped decrease my anxiety. They were not maybe the best days of my life. I was maybe not performing at my peak and I was not killing it at work, and I was not the nicest person but I was fine. I was surviving and if you look at me from the outside you wouldn’t know that I was struggling with insomnia. So that was helpful realization that I had.

Anna Wojcicka:
And it was actually also the fact that it was not that many nights where I only got two or three hours of sleep. On most nights after I starting implementing the sleep window I would generally get more than that and I would fall asleep faster, and I definitely wouldn’t struggle to fall asleep for as long as I did before implementing the sleep window.

Martin Reed:
Yeah. Yeah, I think you made a couple of really good points there that it’s kind of this trade-off, maybe a little bit short-term pain but for that long-term gain. So maybe there might be one or two nights when it’s still going to take you a couple of hours to fall asleep. So maybe you’ll miss out on a little bit that night or the second night, third night. But really, that doesn’t really matter that much because you’re building sleep drive so the future nights are going to get better and a lot of this worry about how long it’s going to take me to fall asleep, how much sleep am I going to get is connected to worry about what the next day is going to be like.

Martin Reed:
So it’s really easy to focus on all of the bad things that have maybe happened in the past and attribute them to a bad night of sleep. When in reality the amount of sleep we get doesn’t have as much impact on our days as we often think, and some of us can be quite surprised about how good or how productive our days are, or just some good moments during the day even after just a couple of hours of sleep and that’s something that’s really important to bear in mind too.

Anna Wojcicka:
This was a big source of my worry. So the next performance and how I would feel the next day was stressing me to the point that I was having nightmares about going to work and not being able to remember anything, to being in a meeting or giving a presentation and forgetting things completely, and it never happened in real life. So like I said, sometimes I was not feeling at my best but it was never as severe as it would appear to be in my dreams about this problem.

Martin Reed:
Yeah, absolutely. That’s really important to consider. I like to ask people, “Have you ever had a good night of sleep and had a bad day? And if you had then it shows that a good night of sleep doesn’t always mean a good day so therefore a bad night of sleep doesn’t always mean a bad day.” It’s really the quality of our day is largely down to what we decide to do during the day rather than how well or how poorly we sleep.

Martin Reed:
so I think you mentioned that you gave yourself this six weeks, so you set it and forget it, gave yourself six weeks. You got those results that you were looking for I think you said after about the four week mark you felt that you were doing really well. Then I remember around the six week mark you went away for a weekend and there was a time difference, you went traveling, noticing sleep disruption. Can you talk us through that? What happened next? This is one of those things, you know, sometimes when your sleep confidence is a bit fragile then you might start to worry again and think these techniques aren’t working so can you just talk us through that? What happened?

Anna Wojcicka:
Oh, yeah. So I went on holidays. I went to Russia, which is three hours ahead time zone-wise from where I’m currently living which is Ireland. And I remember I was traveling with my boyfriend, we arrived at the hotel it was three AM which means it was 12 AM in Ireland and I was still all wired from the travels, but of course, it was three AM so it was time to go to bed. I was not feeling sleepy but we were in a hotel, it was middle of the night, I had nothing else to do, my boyfriend went to sleep so I went to sleep and I didn’t sleep. And I think I maybe got two hours of sleep that night. I spent the night basically lying in bed and thinking about the next day, and how awful it was going to be and how I’m not going to enjoy myself on holiday, and how much my life sucks because of my insomnia. Basically feeling sorry for myself.

Anna Wojcicka:
And the following day was okay. The following night I helped myself with quite a bit of alcohol, I slept through the night and then that gave me quite a lot of anxiety the following day which led to another bad night. So, overall I had three pretty bad nights and I remember after coming back the first night was also really bad and I was like, “Great. I fell back into a pattern. I destroyed everything that I built up over those six weeks.” But I think that’s where the problems ended. So the next night I slept like a baby and I got a feeling that … I think perhaps all the sleep drive that I had built over the weekend was helping me sleep even better, and after I got back to the familiar conditions and I got back to my routine I went right back to sleeping throughout the whole sleep window and feeling good.

Martin Reed:
Yeah, I think that’s a perfect example of sleep drive winning in the end. Sleep drive always wins in the end. High levels of worry and anxiety can definitely disrupt sleep and suppress sleepiness but it can only ever last for so long. Eventually, sleep drive gets to this point where it makes sleep happen, and it’s really important to recognize that when you’re traveling, especially when you’re crossing time zones sleep is always going to be disrupted. It would be unusual for you to have gone to your hotel that night and slept like a baby. Something people do. It sounds like your boyfriend did but that’s more on the unusual side. Most people will struggle for a few days at least when they’re crossing time zones. So I think that your sleep recovered for two reasons. One, first of all, sleep drive just made you sleep again and second of all, you didn’t engage where you resisted the urge to engage in all these behaviors that then perpetuate that temporary sleep disruption.

Martin Reed:
So it sounds like you weren’t tempted to start going to bed earlier again, trying to nap during the day, modifying your day, you stayed really consistent with the techniques and so your sleep just got back on track as soon as the travel disruption wasn’t an issue anymore.

Anna Wojcicka:
Yeah, that’s right. I knew better by then than to go to bed earlier. It didn’t even cross my mind. I definitely knew that as soon as I came back I was going to go back to the exact same sleep window, and I was going to implement the exact same routine that led to improving my sleep the first time around. So that obviously worked.

Martin Reed:
Yeah, so staying on that note of travel. I remember the, I think it was, this is three months after you first started with sleep restriction now. You were getting around seven or eight hours of sleep each night and you’d gone on vacation again. Was that trip a little bit later on, was that any different? Were you struggling again during that trip or were things a little bit better that time around?

Anna Wojcicka:
I wasn’t. So all the way to when the trips started I was definitely sticking to a consistent sleep window. I extended it by then to seven hours or seven hours and 15 minutes, but I was definitely trying to go to sleep at the same time every day and wake up at the same time, and definitely not sleep longer than that. But I went on holidays and I was little bit afraid of course because there would again be a time difference. This time of seven hours and I didn’t know whether I would be able to keep consistent sleep schedule even in that time zone, and also we would be moving around quite a lot. So I would be in different hotel rooms in different places. So that would introduce quite a lot of uncertainty, but I think by then my sleep had already recovered to the point that I didn’t struggle at all. It was not an issue. I think I was also not stressed with work. So that was definitely helpful but I was going to bed together with my boyfriend. I was sleeping maybe eight hours a night, seven and a half eight hours. Sometimes longer and would sometimes sleep in in the morning, and sometimes I would go to bed later and sometimes earlier. And it was generally I felt like a normal sleeper again. You know?

Martin Reed:
Yeah.

Anna Wojcicka:
I forgot what it was like to not think about sleep and not worry about sleep, but during that vacation I experienced exactly that.

Martin Reed:
Yeah, I wonder if it was just you were at that point because it was further down the line here you just had a little bit more confidence in your sleep so you naturally worried less about it, and because you were worrying less about it, putting less pressure on yourself to sleep, sleep was easier that time around on that vacation. I think it’s also important to recognize that when you’re on vacation what do you go on vacation for? These holidays, it’s the daytime activity that the focus. You have so much fun during the day what really happens at night doesn’t really matter. It’s all these activities and all these things you’re doing during the day that count, but yeah, when you don’t have that sleep confidence all your thought process is about what’s going to happen at night but if you just shift your attention to all the great things your going to be doing during the day then you won’t be worried about sleep so you’ll have a better day and sleep will become easier as a result.

Anna Wojcicka:
Yeah, that’s exactly right and I remember going on holidays during the year and a half where I was really struggling with insomnia and I would go on longer holidays where I didn’t have work-related worry and I would have horrible sleep. So it’s definitely not a given for me that I would be sleeping well during the holidays, but I think the confidence that I have built during the three months of sleep restriction and consistently decent, okay, good sleep during that timeframe helped me sleep well and have a nice holiday. And also remain active during the day and focus on what I was doing during the day rather than what would be happening with me during the night.

Martin Reed:
Yeah, exactly. One thing I wanted to touch upon was you were extending out this sleep window as your sleep improved. How did you decide when to extend that window it? You know, and allot more time for sleep and how much … How did you do it basically?

Anna Wojcicka:
Right. So I went in 15 minute intervals. So I started with a six hour sleep window. After I think about four weeks went I had my first week of consistently good sleep I would add 15 minutes, and then I would go maybe in four or five days when I saw consistently good sleep I would add another 15 minutes, then if that wasn’t working for me … I remember going back and forth a little bit. So I was tinkering with it a little bit and sometimes I would add also 15 minutes at the end of my sleep window. It depends what was suitable for my schedule at that time, but it was always 15 minutes and I always needed to have four or five days of consistent good sleep to add the 15 minutes to my sleep window.

Martin Reed:
Yeah, I think that’s a good strategy. I like the 15 minute chunks, because it’s not a big difference so it shouldn’t lead to that much disruption when you first make that change but it can certainly give you that opportunity to see if you’re at that’s stage where you can get a little bit more sleep. And again, when it comes to how often to change it, five days, yeah, I would say that would be the minimum goal I would suggest leaving if you’re able to goa week. If your sleep confidence is really poor maybe even just go two weeks just to really make sure you’re building up that sleep drive, that consistency in your sleep before making any changes just because it can be so tempting to make the change and then one night later you have a bad night, oh, and then go back and you just cut … You’re just caught in this trap of, “I just can’t change this. Anytime I change it my sleep doesn’t improve. It just goes back to where it was.” SO just making those small incremental changes like no more often than five to seven days is really the way to go I think.

Anna Wojcicka:
Right, like you said, I remember once time I went too fast and I added a 15 minutes and then I had a consistent few nights where my sleep efficiency was way below average, and then I needed to go back and then spend another five or six days on my previous sleep plan. Then I could start adding back again, but sometimes I remember I was feeling really eager to get to a certain point. Like for manufacture, six and a half hours seemed like such a long time and I really needed to make the six and a half hours and then the next real goal was seven and I couldn’t wait to get to a seven hour sleep window. Yeah, it sounds weird to me now, it sounds weird when I say it but because right now I don’t really have a sleep window anymore.

Martin Reed:
Yeah.

Anna Wojcicka:
But, yeah. That were my goals for them.

Martin Reed:
Yeah, I see that a lot with people that I work with and I think it’s natural that you’re really keen to make this progress. You really want to extend that sleep window as soon as possible, but the issue is you know from experience that allotting too much time for sleep doesn’t lead to more sleep. It just leads to more time awake. So it is really important to remain conscious of that fact. That more time in bed doesn’t mean more time asleep, but it can certainly mean more time awake and only make those changes when your sleep has responded. You know, when your sleep is showing you that it is ready to try and get more. So yeah, that’s really useful insight.

Martin Reed:
So you touched upon this now. So what’s your sleep like now? We’re right at the end now. What’s your sleep like now and what’s your life like now?

Anna Wojcicka:
So I would say I definitely don’t think about sleep much. I used to think that I need six and a half or seven hours. I think when my body was in more of a state of hyperarousal I needed less sleep, but now I would say it’s more like seven and a half, eight hours and I go to bed when I’m sleepy. Usually, I would read a book in the evening. I still try to apply some of the things related to sleep hygiene that I have read about. So I definitely don’t use my phone and watch news in the evening, but I would read a book and then when I start feeling sleepy, which is around midnight I will go to bed and then fall asleep within 15 minutes. And I wake up around eight AM.

Anna Wojcicka:
I try to wake up consistently around the same time on weekends but I occasionally allow myself to sleep in, and sometimes on weekends I also go to sleep a little bit later. So yeah, I would say it’s a fairly boring sleep schedule that sounds quite average for most people but it’s great.

Martin Reed:
Yeah, well, it sounds like you reached the goal because the end goal is you’re just at this point where you don’t really think about sleep. It’s not this important part of your life anymore and it’s just something you don’t spend any time thinking about so it does seem boring to talk about or to think about.

Anna Wojcicka:
Yeah. Yeah, right and I honestly didn’t think that I would get to this stage because I was obsessed with it and I would constantly think about it and I would constantly talk about it, and I would constantly research it and right now it’s just an afterthought.

Martin Reed:
Yeah. Absolutely. All right, so I’ve got one last question for you. I really appreciate the time that you’ve spared today. So if someone with chronic insomnia is listening and feels as though they’ve tried everything, they’re beyond help, they can’t do anything to improve their sleep, what would you tell them?

Anna Wojcicka:
There is definitely something that you can try. Cognitive behavior therapy for insomnia sounds awful but it’s something that really helped, me and if it could help me it can help anybody. I am pretty sure of that.

Martin Reed:
That’s great. Thank you so much for your time, Anna. I think people are going to really identify with your experience and I’m really hoping that it will motivate them to give these CBT-I techniques a try because after all, if they can recognize part of their own insomnia in your story and you’re now at the stage where sleep is not an issue for you that means that they can be just as successful as you.

Anna Wojcicka:
Thank you very much. It was a pleasure.

Martin Reed:
Thank you.

Martin Reed:
Thanks for listening to The Insomnia Coach Podcast. If you’re ready to implement evidence-based cognitive and behavioral techniques to improve your sleep but think you might need some additional support and guidance, I would love to help. There are two ways we can work together. First, you can get my online coaching course. This is the most popular option. My course combines sleep education with individualized coaching and is guaranteed to improve your sleep. You will learn new ways of thinking about sleep and implement better sleep habits over a period of eight weeks. This gives you time to build sleep confidence and notice results without feeling overwhelmed. You can get the course and start right now at insomniacoach.com/online.

Martin Reed:
I also offer a phone coaching package where we start with a one hour call. This can be voice only or video, your choice, and we come up with an initial two-week plan that will have you implementing cognitive and behavioral techniques that will lead to long term improvements in your sleep. You get unlimited email-based support and guidance for two weeks after the call along with a half-hour follow-up call at the end of the two weeks. You can book the phone coaching package at insomniacoach.com/phone.

Martin Reed:
I hope you enjoyed this episode of the Insomnia Coach Podcast. I’m Martin Reed, and as always, I’d like to leave you with this important reminder — you can sleep.