[Steve]

I am hoping it will work Deb. Just not sure I want to jump in with both feet yet. I don’t think there is a problem if I use an SW for awhile until I am more comfortable with the process of “letting go” yet. It worked last night as when I was laying there and confronting any bad thoughts or ideas, I was prepared to accept whatever happened that night. After all, I knew it couldn’t be any worse than getting up to do SC and not having that work. I want to see how it will work over the next several nights. I am just trying to prevent fragmented sleep by using the SW for awhile longer and as I said, I don’t think an SW will hurt the ACT process.  It will just delay it some.

[RonA]

Sorry to hear the consolidate sleep went away.  I think ACT is great, especially the mindful practices to help accept our current reality and hopefully reduce anxiety.   I believe it makes sense to stay in bed if your are calm and not tossing and turning.  I would just question if it makes sense to have a longer SW when your sleep is now more fragmented.   I think SR is the most important tool in CBT-I and we need to be 100% consistent on the wakeup time and not moving the window until we have 85% efficiency.  While SC is important, I believe you can cure insomnia with SR alone.  Does Martin agree with the longer sleep window?

Either way good luck.  This is quite a journey!

[Deb]

I know it’s scary to jump in with both feet. I tried to start ACT over 7 weeks ago but had many stops and starts. But once I finally and fully committed, I starting seeing results. I realize that it may look as though I just happen to be lucky because its happening so quickly for me, but I practiced this for a month back in March and started getting the hang of it back then. But at the time I kept worrying about the light sleep and then got derailed. This time when I finally jumped in I knew that light sleep was normal and didn’t worry about it. Also it was easier to get to that place of “acceptance” because I knew how it “felt” from my earlier practice. The sleep doctor has told me that that’s the hardest thing for people – getting to the place of acceptance.

I think that for some people, SR & SC doesn’t work so well because maybe they tend to be more anxious than others. This might be you, Steve. In this case I think it’s better to deal directly with the anxiety, which  is what ACT does. For some people, worrying about their sleep window and doing SC just becomes another source of stress and anxiety. In that case it’s better to give them all up and instead relearn how to relax in bed. Then sleep will come naturally because the mind is no longer getting in the way. The body knows how to do this and has been doing this all of our lives. We just have to remember how to let go and then the body will take over.

[Steve]

RonA – I still get consolidated sleep. It’s just that the time I get it seems to be shorter and shorter. Right now, I can’t say my sleep is fragmented because after that initial couple hours of sleep, I pretty much am awake until the alarm rings. If I do sleep longer, I might get a couple wake-ups but they don’t last long. At least not long enough to say the sleep is fragmented. I never really discussed the slightly longer SW with Martin. Only the part about staying in bed if I can’t sleep. I can always shorten the window if I find it’s too long and ACT doesn’t seem to work. But I have faith in ACT this time as now I know I can accept whatever sleep I get at night because I survived bad sleep before.

Deb – Thanks for your response. I’ll see how I do over the next couple of nights and then decide whether to jump in with both feet. I don’t think acceptance will be too much of a problem as I’ve learned to accept whatever sleep I get at night. I know I won’t die the next day. I also know what they mean by not forcing sleep. If I wake, I just stay in that wakeful state and try to confront my sleep fears and irrational ideas.

[Deb]

Ron – you may want to read the 2nd and 3rd chapters chapters on “Acceptance” and “Welcoming” from the Sleep Book. It provides a gentler approach to dealing with our fears and thoughts rather than confronting them, which may only push them away temporarily. With these techniques the fearful thoughts, feelings and sensations lose their power and we no longer fear having them.

[Steve]

Deb – Do you mean Ron or me? I know what the book says about accepting your thoughts and I do agree with that. But I also believe that both CBT-i and ACT have several good things in their content. In CBT-i, providing evidence against a thought is a good way of diminishing that thought’s power over me. As an example, when a thought says if I don’t get sleep, I will feel terrible the next day, reminding myself that I have survived poor nights of sleep before diminishes that thought’s truthfulness. There are good things in each method. I want to combine the best of both. It will take awhile but I believe I can beat this.

[Deb]

I meant Ron. Yes, that’s true what you say about challenging your thoughts. I said the same thing to myself about the next day, so I’ve used that method as well. Like you said, there’s good in both methods. It’s best to use whatever works for you.

[gsdmom]

Hey Deb,

After reading your posts I’m going to order The Sleep Book by Dr Guy on my Kindle. I’ve read reading on a Kindle is not that bad if you do it for under an hour and dim the screen. At this point I have nothing to lose. Sleep Restriction brings on too much anxiety for me. Stimulus Control has had some benefits, but I’m getting tired and a bit anxious with the routines of it. I’ve never really been a depressed person but have issues with anxiety and it sounds like the ACT addressess this. Thanks again for your feedback to everyone!

[Deb]

Sounds good, Gsdmom. I didn’t like the idea of always having to wait until I’m completely drooping before going to bed! Now I go to bed just like I used to. Happy to help out by sharing my experience. The book will help you the most though.

[Steve]

I know it’s late in the day but I had to comment one more time. I know exactly what you mean Deb. A lot of times I am exhausted by 9:00 or 10:00 but I can’t go to bed until my SW starts at 11:15. That’s tough to keep doing, even if eventually my SW will expand.

[Deb]

Steve – There’s a part of me that wonders if ACT will work together well with SR. The whole focus of ACT is learning to relax about sleep. But if part of you is still worrying about the sleep window and also about not getting enough sleep since your sleep time is so short with SR, that it will be harder to relax.

I went to bed when I was tired (but not exhausted) and when I was having the light sleep, I gave myself extra time to sleep in so that I wasn’t a zombie the next day. So sometimes I was sleeping 9 to 9.5 hours or more, even though it was light sleep. Now I’m starting to wake up earlier because my sleep is getting better. This is  closer to my normal wake up time. So my whole attitude about sleep is a lot more relaxed than when doing SR.

Just my two cents.

[Steve]

You might be right Deb but I’m not too concerned at the moment and here’s why. When I first did the CBT-i/ACT mix Wednesday night, after a short spell of being awake, I fell back asleep again for about an hour and a half and slept till just before my alarm went off. If that happened too many times, I would definitely increase my SW. Last night, the second night of the mixture, I increased my SW to 6.5 hours (a half hour increase) so I wouldn’t have to worry about not having enough time to sleep. It worked in that I woke up an hour before my alarm would go off and I couldn’t get back to sleep so I just laid there and did my mindfulness/acceptance exercises for the hour. When I start sleeping again to close to the time the alarm goes off, I’ll increase the SW  again. I did find one odd thing about last night. Lately, I have been going to bed and waking up about 2:00 in the morning. Last night, when I went to bed a half hour earlier, I also awoke a half hour earlier at 1:30 in the morning. It seems I am conditioned to sleep a certain amount of time before my first wake-up.

[Deb]

Glad you’re not worrying, so this may work fine for you. One thing – just use mindfulness for a few minutes to ground yourself when needed and to help you get back to the relaxed state of acceptance. Don’t do focused mindfulness exercises for a longer period of time in bed because it will just keep you awake. The more focused exercises are to be done during the daytime to help make it easier to use mindfulness when you need it at night. I asked Dr. Kat about this and this is what she told me.

[Steve]

Okay. Thanks. That makes sense. Two other questions. Do you use a sleep diary at all or did you stop that? I want to try to eliminate my thoughts during the day on insomnia and I am thinking that filling out the sleep diary just returns my thoughts to the fact I can’t sleep. Also, so when you are lying in bed and can’t sleep and you have done your mindfulness, what are you doing? Playing with your thoughts you labeled? Welcoming new thoughts and creating spaces for them? Focusing on your breathing to keep your thoughts from wandering? What do you do to keep your thoughts from wandering? Of course, you get a lot of sleep now so you may not have that problem. My mind still wanders so I have been noticing unwanted thoughts and then putting them aside by doing my breathing. Thanks for all of your help with this. Being able to stay in bed instead of getting up to do SC has been a huge blessing.

[Deb]

I have been using a sleep journal all along, for months now. But I may stop it soon because I’m sleeping normally so my entries are all looking the same.

After I ground myself then I just relax and don’t think about anything in particular – just random thoughts like I used to before the insomnia. So my mind is wandering, which is normal. If it were go to negative thoughts then I would use the tools to let go of those. I think that when you begin to experience what it feels like to “let go” and be in that place of “acceptance” it will start to get easier to get to that state of mind again. Just accept whatever happens – that you may not sleep much tonight, but oh well. Or, I may be tired tomorrow, but oh well, I can deal with it again like I have been doing. Accept and then let go of any effort. I think Ron is getting the hang of acceptance. Read what he read earlier. He can probably help you with this too.

[Author]

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