[KarenP]

Thanks Deb for asking!
I am now returning home from a 10 day road trip. I’ve been blessed with for the most part, 7 -8 hours a night since I last posted. A good 8 week run. Hubby and I are driving home now from a 10 day road trip visiting family. I’ve slept 3 different places and have surprisingly slept really well, even watching tv in bed every night because we were in hotel rooms. It was a huge confidence boost for me. The night before we left and 2 nights ago, I struggled with 4 hour nights. The first time I was anxious and wound up
about getting on the road and couldn’t sleep. Two nights ago, I had a hard time dealing and shutting down racing thoughts after a family reunion. I honestly think it was because I went 2 days without meditating. Tried hard to accept and welcome the anxiety and racing heart, feel like I need to revisit my ACT toolbox. Sleep has been pretty effortless, so it kind of worried me. Last night however was a good night, my sleep drive was high.

Just finished listening to Martin’s podcast with Nick. It was really worthwhile. They talk a lot about ACT. They refer to it as the graduate school of CBT-I. I totally agree with that. I don’t think I could have done ACT without the foundation I got from Martin. The best thing about ACT for me is the help it’s given me in dealing with the anxiety surrounding my insomnia. Practicing mindfulness meditation has been a game changer for me.
Thank you all for your sharing and encouragement.

[Deb]

Karen – that’s great that you’re sleeping well! It sounds like you still have some anxiety though, which I know I do too. Having this insomnia was traumatic and there’s still some fear of it coming back. So sometimes like last night I find myself worrying that I might have trouble falling asleep after I get in bed, for whatever reason. Then I get up for awhile and go back when I’m feeling more tired. I’ve done this now for a few nights and it’s messing up my schedule.

So I feel as though I’ve healed from the insomnia, but now I’m in a stage where I need to heal from the fear of it coming back. Sort of like a secondary level of healing. Oh well. Wish I could be completely free of this and any after effects and go to bed completely worry free like the old days.

[Borgesbi]

Steve, Featherly, and Gdsmon, I’m so happy to know my post helped even if just a little. I know my sleep isn’t perfect but whatever I can do to help anyone through this (if I can) I’m eager and more than happy to. Ending at least the psychological struggle with insomnia is already a huge relief.

Another point I thought of that might be worth mentioning since I noticed it’s a big one for me: acceptance of wakefulness. We talk a lot about accepting difficult feelings and thoughts of insomnia but I think at the root of it all is simply our lack of acceptance towards our wakefulness. Being completely and utterly ok with being awake in the middle of the night has helped me drop the worries, the monitoring, and anxiety (for the most part). I think acceptance of wakefulness itself is what brought the careless feelings towards insomnia. Sometimes I still forget and get caught in not accepting, but the more I practice, the quicker I remember to accept just being awake. Paradoxically, almost always when I truly and whole heartedly accept wakefulness without any expectation to sleep whatsoever, I fall back asleep. If I don’t, it’s only because I don’t have enough sleep drive yet!

As always, hoping everyone will have a restful evening tonight – no expectation to sleep, just rest 🙂

[Steve]

Glad a lot of you are doing better. It’s a slow process but it can be done. Unfortunately, I had two bad nights in a row Saturday night and last night. Especially last night when I only got around 2 to 2 and a half hours sleep at the beginning of the night. Then I lay in bed for 5 hours trying to accept. I did catch myself challenging my thoughts of frustration and anxiety so I had to change my thinking to thoughts of acceptance. Some other unwelcome thoughts come in as well and I accepted them but I just couldn’t get back to sleep. So, I am really all over the board with my sleep. Surprisingly, I don’t feel too bad today. I am thinking of trying an experiment tonight which is probably a no-no. I am going to take some Passion Flower to see if that helps the anxiety any. If there are any side effects, I can always stop since they aren’t prescription level meds. Any thoughts on this? I know we aren’t supposed to take supplements since if it does work, we will start to believe that we need them to sleep. But if I can reduce my anxiety some, that would be great!

Borgesbi – Your comments on acceptance of wakefulness are good ones. You are right in that it’s just plain hard accepting that we are awake in the middle of the night. I can accept the unwelcome thoughts about other things that come my way but actually accepting being awake in the middle of the night is very difficult. I tried to let my mind wander last night so I could go back to sleep but I couldn’t, so I decided to get to know my insomnia again and stayed up with it some. I almost fell back to sleep a couple times but just couldn’t get over that edge. I probably need to learn to accept that wakefulness more if I want to return to sleep. Thanks for the comments/advice.

Hope everyone else had a better sleep the last couple of nights.

[RonA]

I have not posted in awhile but thought I would give an update on my struggle with insomnia. I too have read the Guy Meadows book and am a big believer in ACT. ACT as a tool has helped me tremendously in dealing with my OCD issues and many think Insomnia is just another OCD anxiety based condition. My sleep today is much better than it was. I now consistently get 5 hours most nights and some nights have even slept 7+ hours which was unheard of before. I attribute much of this success to being able to reduce my anxiety using ACT techniques and now lying in bed longer without getting extremely frustrated like I used to. This has enabled me to fall asleep more often, even though I still have too many awakenings and light sleep during the night.

While I have seen much improvement, my sleep is still too inconsistent to consider myself “cured”. I think the problem is that I have been real lax with sleep restriction and while I am sleeping longer, my body has still not adopted to a consistent schedule. So this week, I have once again started with a 6 hour sleep restriction window along with using ACT when I am awake in bed(which effectively replaces the despised Stimulus Control). I think I was not ready to eliminate SR which hurt my sleep drive and led to inconsistent sleep.

Hopefully combining the two tools will make my sleep stronger and more consistent like a normal sleeper! I am actually surprised ACT has not been formally taught and included as a tool within CBT-I, along with breathing exercises and progressive muscle relaxation for reducing anxiety.

[Mac0908]

Thanks for sharing Rona.
Care to share any of the specific ACT exercises that helped you along the way ?

[Deb]

Ron – great to hear from you again and glad you’re doing better. Hope your plan helps you get better sleep. About ACT not being formally taught, I wonder if most people just never heard of it. Just like a lot of sleep doctors never heard of CBI-I, ACT is even less known since it hasn’t been around that long. Also, probably those who have heard about it, haven’t heard much success stories. Like many of us who first started ACT without any help, it was confusing and takes some time to develop the skills. So they might have heard more stories of people who tried ACT and then gave up.

Borgesbi – like you said, acceptance of wakefulness is the key. When I learned to accept this, then I finally started to fall asleep. Dr. Kat said that this is the main factor that determines how long it takes people to recover.

Steve – I took a medication for anxiety, Effexor, and I think it took some of the edge off my anxiety. So I see nothing wrong with taking something for the anxiety.

[RonA]

Deb, I think ACT as a tool has actually been around longer than CBT-I. Personally, I believe it it most effect as an alternative for Stimulus Control and used in conjunction with SR. It is certainly more difficult because SC and SR are very prescriptive and ACT is all in your head.

Mac0908, I developed a hyperawareness of body sensations like breathing during the night with my insomnia, I used ACT tools like welcoming and imagining a space within myself for my “awareness” to coexist. This has helped ease my frustrations and much of the hyperawareness then also subsided. This was a huge help to keeping myself in bed and sleep longer.

Steve – have you ever tried Xanax for your anxiety? It is a miracle worker but has to be used sparingly. I have found that on a very difficult night, taking a low dose Xanax 4-5 hours before bedtime is very effective to eliminating sleep onset anxiety.

[Deb]

Ron – I was talking about ACT for insomnia developed by Guy Meadows.

[Deb]

Maybe it should be called ACT-I just like cognitive behavior therapy specifically for insomnia is called CBT-I.

[Steve]

Ron – I have tried Xanax when my doctor first started prescribing meds for me. I used it every now and then but I don’t consider it to be a good sleep drug. There is no question it put me out for the night but it isn’t the type of sleep I wanted. I also had to deal with some withdrawal effects the next day. I prefer to stay away from ALL benzos as the risk of addiction isn’t worth it.

Deb – Did you stop taking Effexnor or are you still on it? I know last time we discussed this, you said you were waiting to sleep better before you withdrew from it. Also, another question for you. You said acceptance of wakefulness is the key. When you accepted your wakefulness, did you just lie there in quiet wakefulness but fully awake getting to know your insomnia and accepting your unwelcome thoughts or were you just lying there letting your mind drift where it wanted to go? There is a difference there. In the first case, you are kind of cognizant lying there with your insomnia. In the second case, you probably aren’t too cognizant and just letting your mind go where it wants to. Admittedly it’s a subtle difference. When I am partially awake, I try to let my mind drift rather than wake myself up fully to concentrate on quiet wakefulness. Doesn’t always work though and I wonder if I should force myself to be fully awake so I can then confront my unwelcome thoughts. I still think I’m getting better even though I had two bad nights. And even if I did lie in bed for 5 hours last night, it was better than doing SC. I would have felt much worse because I wouldn’t have gotten any rest. I would have been up trying to do an activity which would have tired me out. I am glad I tried CBT-i and agree that it was a good base but I prefer ACT.

[burn]

I also liked the interview with Nick Wignal. In fact it prompted me to introduce one CBTI rule into my practice: wait to get sleepy before going to sleep. We will see how it goes. I also liked the Simpsons story of the interview and I will try something similar. I decided to give myself some time IN BED reading/watching something easy before sleep. In fact that what I was often doing before insomnia. Then, when I tried rigid SRT, it was very frustrating to intentionally sit in leaving room waiting for sleep window. Now, I will allow myself to just lie in bed (rest for body) and watch something till get sleepy (don’t forget to turn on blue light filters/night mode on your devices!).

Regarding other updates, I think that frustration is my current obstacle. My sleep anxiety is minimal, yet I still have sleepless nights, sometimes two in a row, even when I lie calm and relaxed toward wakefulness. While anxiety is easy to befriend and let go, general frustration with sleep/insomnia had proven to be more challenging. I suspect that occasional waves of frustration during daytime contribute to sleeplessness.

[Steve]

Burn – I agree with you. Usually I can welcome the anxiety and it goes away pretty quick. Last night was an exception and I think it was because I was lying there for five hours. But mostly, it’s the frustration. No matter how hard I try to welcome it, it keeps rising the longer I have to stay awake, even if I am lying there in quiet restfulness. Then again, is that a contradiction? Lying there in quiet restfulness but frustrated?

[Deb]

Steve – Just this week I started weaning myself from Effexor. I’ve had the minimum dose of 37.5 mg and I think I won’t notice the difference when I’m off it completely. That’s how it was several years ago when I weaned myself after having taking it for maybe 9 or 10 years.

When I accepted my wakefulness, I would just lie there and do nothing and let my mind wander, just like before the insomnia. I don’t think frustration is compatible with acceptance of wakefulness, at least not while you’re in bed. You want to do nothing and think nothing in particular. When you’re frustrated, you’re “struggling” with your insomnia again. Check out page 72 in the book.

Whenever I “caught myself in the act of struggling” in anyway with my sleep, then I knew that I needed to push that “wakefulness acceptance button” again. Lots of times I would get up and journal because it was hard for me to get out of that struggling state while in bed. Once I started writing in my journal my mind would become clearer and then I would realize that I was struggling again, smile at myself, push the button and then go back to bed (and usually fall asleep).

[Steve]

Deb – Thanks! That’s very good advice. The frustration has just started for me within the last two weeks. I think it’s because I was doing rather well getting between 6 and 7 hours a lot of nights but then regressed some. So I just felt frustrated on awakening at 2:30 or 3:30 in the morning and not being able to get back to sleep. I think a lot of times that while I think I am accepting of being awake, I’m really trying to force myself to go back to sleep and we all know you can’t force sleep. Last night was a good example. I had a wonderful evening out. I got home a little late and went to bed and fell right to sleep. I was even having a good dream and then as is usual lately, I suddenly woke up. That was very frustrating which most likely was the cause as to why I couldn’t get back to sleep. I think though that I am going to have to learn to deal with the frustration the night before I go to bed and not after I wake up. Preparing myself for the wake-ups will probably be less frustrating than dealing with the frustration after I actually wake up. I think it would also help for me to get out of bed from time to time when I notice myself struggling. I don’t Journal though and it never was a good hobby for me. But maybe if I went into the other room and petted the cats for awhile that would be a good equivalent. Or even just walked out to the kitchen to get a drink of water. I don’t mean every time I wake up as that would be too much like doing SC. I just mean those times when I catch myself trying to force sleep and can’t stop it. Getting a couple minutes away from that struggle might be a good way for me to “push that button” as you put it.

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