[Steve]

Or, in regards to my last post, if anyone can think of something else to do besides journaling, let me know. Thanks.

[Mac0908]

After a rough week last week of semi spiraling, I quickly began (surprise, surprise) reverting back to SRT Saturday night. I did well Saturday, sleeping through my entire 11:30p-6a window, but then Sunday and Monday nights were bad nights with awakenings. Used some ACT things like focusing on my breath and the touch of my pillow, remained calm overall, but still never fell back into that deep sleep. It’s as if once SRT kicks in and I begin sleeping through the 11:30p-6a window nicely, there’s just no weening off. I’ve had relapse after relapse. The underlying anxiety is just always there and I’ve never seemed to kick it. It always finds a way to creep back up once I start to get comfortable, for whatever the reason. Absolutely shot today. Will this ever end? Ever?

[Deb]

That sounds like a good plan, Steve. Just do something to get your mind off the struggle and frustration. Petting cats is always a good idea! My faithful cat has been with me practically every night I couldn’t sleep for the whole 9 months of insomnia. He’s a grey and white tuxedo and lays next to me on the couch. He stretches out on his back revealing his soft white tummy. Stroking that soft, warm tummy always gets my mind off my troubles!

[Deb]

Hi Mac – So sorry for your bad night. Maybe it’s time to convert completely over to ACT since the same thing seems to be happening over and over with SRT. The anxiety is always under the surface ready to rear its ugly head. I would get help if I were you. Maybe contact Dr. Kat from Guy Meadows clinic and work with her. She’s really helpful. Or maybe get in touch with the guy that Martin interviewed recently, Nick Wignal (mentioned in some recent posts here). He uses both CBT-I and ACT and seems to have a lot of experience working with more complicated cases. Take care!

[Mac0908]

Thanks Deb but honestly I’ve read Guy Meadows’ stuff before. I get all the ACT exercises but I think my problem is that I just don’t know how to correctly implement them. Maybe I will give his material another look. I know I might sound miserable on here sometimes but I’m still very happy that I’ve made what I feel is significant progress these last 9 months. I feel like there is just one final (maybe big) thing I need to tweak to tone down my sleep anxiety for good so I can enjoy a long term recovery. I am night and day compared to where I was one year ago mentally, and even physically as well seeing as how back then I never had extensive good stretches like I’ve enjoyed this year.

[Deb]

I’m having a bit of a relapse again, but maybe it’s actually anxiety about a relapse. I was very tired last night but couldn’t fall asleep. That old fear was in the back of my mind. I got up and pulled out Dr. Guy’s book and started flipping through the section on relapse. Funny how even though you have read something before, this time it jumps out at you as if you never read it. There was a very encouraging sentence right at the very end of the section (page 214), “Repetition of the process reduces the power and frequency of insomnia recurrence until it fades away.” In other words, there will be relapses, but over time they will fade if we practice the tools when we relapse.

So then I went back and re-read the whole section on relapse. I realized that I’ve slipped back into my old pattern since the first relapse a couple weeks ago. I started having a drink again before going to bed, hoping it will knock me out and no fears will creep in. In a way I’ve been extending my first relapse by slipping into the old pattern of trying to push things away instead of accepting my fears and my insomnia. So it’s time to get back to the place of acceptance.

There’s an interesting testimony there too (page 213) where a woman talks about how she relapsed after six months. She desperately pulled out all the tools and practiced them one after another trying to “fix” things and get back to normal. Finally she was able to step back and recognize what was happening and then was able to let go and go back to “doing nothing.” So interestingly, we can even use the insomnia tools to keep us awake!

[Mac0908]

Good post deb, and a good reminder to those of us like myself who suffer from relapses. It’s very true that there will be relapses as I and many others know all too well, and it’s a must to know how to handle them. I just don’t understand the testimonial fully. She says she went back to just “doing nothing”, but if she was legit relapsing I’m assuming she reverted back to some form of SRT?

[Mac0908]

Continued…

I feel like my relapse problem is pretty simple for me to figure out. There’s no irony imo that my anxiety subtly starts creeping back in after a few weeks of being off SRT. What happens imo is just that. I’m off of SRT and now I start thinking again, uh oh, maybe going to be at this time is a tad early? Maybe I shouldn’t have lied in bed until 8am on the weekend the other day?

I wonder Deb, in all this time have you ever read about or think I should possibly consider the idea/experiment of simply letting go COMPLETELY of any thoughts of rules/regiments? For example, just stop caring. Stop caring about bedtimes, wake up times, or anything else. Ok maybe not lie in for 2 hours every single weekend, but instead, just stop even thinking about my post SRT lie in’s in general whether they are an hour or even 2. Go to bed at 9pm on some nights and act as if its no big deal.

The bright side about me is that a majority of the general bedroom anxiety is gone. The only sleep anxiety I get these days is that of fear of relapse.

[delv-x]

Hi Mac,

I believe what she meant by doing nothing is to not try to fix it at all. If she was just able to brush her teeth, read for 15 minutes, shut the lights out and drift off and then had a day or two or three, don’t change anything. Busting out the tea, hot bath, 2 hours of mindfulness, implementing a strict 5.5hr SRT and going thermonuclear on insomnia may just make the relapse longer. Accepting that tonight sucked and moving forward probably is better than assuming that there is something very wrong and will stay that way forever.

I still have bad nights and I can never predict nor find any trigger other than body/mental anxiety. Some days/nights do suck and the worry train goes up but I know I’ve been able to string many satisfactory nights and make my day much more comfortable. I can’t “fix” it, I can only really provide my body about 6-8 hoursish of sleep a night and hope that most of it is in some form of sleep.

[Steve]

Deb – I wouldn’t worry about the relapse as we all know it can happen. You might want to consider though that you could be getting rebound insomnia from weaning yourself from the anxiety medication. If that’s the case, continue “doing nothing” about the relapse and it should pass.

I have to thank you again for your advice. Last night, before I went to bed, I prepared myself that I was going to wake up early and not to be frustrated about it. I did sleep for 4 hours and woke up but I wasn’t frustrated at all. I was able to fall back asleep. It was a combination deep sleep/light sleep being in and out of it but it was sleep. I am still having some problems today but I feel much better than yesterday. Hopefully, a couple of these nights of at least 6 hours sleep and I’ll be back to where I was. I just have to keep myself aware that I will not be cured overnight and that it will take awhile, even after I start sleeping normally again. When I keep that in mind, I won’t suffer from frustration when it doesn’t happen right away.

[gsdmom]

Deb – hoping your fears about relapsing fade away soon. I think to want to push away our fears instead of accepting them is a life long habit for most people and learning to accept, embrace and make friends with our negative thoughts is a new skill, and just like if you were to learn something new like playing the piano, it just takes time and practice. Your dedication to overcoming this is inspiring! I think most of us here would have to say that having insomnia is one of the worst experiences of our lives. I’ve had very difficult times before but not the intensity and duration of this sleep deprivation, so of course you would get fearful thinking about it again.

I had almost a full week of decent sleep and minimal time for sleep onset! This has come about 9 weeks after starting ACT. Last night was not the best, I couldn’t fall asleep until about 12:15am, but earlier in the evening I had to deal with a mouse in the house, a new outbreak of ants, and I found evidence of termites eating my daughter’s headboard! All late in the day, so dinner did not get started until 8pm and didn’t take time to unwind and meditate. But I did sleep for about 6-6.5 hours so still feeling good.

One of the things that gave me anxiety last night was something I experienced the night before and a few weeks ago. I tried to look it up online and I think its classified as “confusional arousals” For me its the space between sleep and feeling like I might wake up in the middle of the night. One time I felt like I was in a black hole and kind of had amnesia, it was very scary, and the other night I felt like I lost my personality and bearings around the house. I remembered this happened once before and then I tried not to get scared and also remembered my sleep doctor told me I have more light sleep time, and when he said to tell yourself just to go back to sleep, you are having light sleep. So I did. I read this can happen to people after a lot of sleep deprivation and a few other things. Has anyone else had the feeling of waking up very confused once your recovery started, or at anytime during insomnia?

[Mac0908]

Deb, did you catch my second post from earlier? What do you think about all that? Perhaps there is some real substance in the whole “do nothing” thing. Meaning that, when we have a bad night or two after a good couple of weeks, doing anything at all, even as simple as going to bed later than normal to try and “reset” things in a SRT kind of way is a mistake?

• This reply was modified 4 years, 6 months ago by Mac0908.

[Deb]

Mac – sorry for not getting back sooner. It turned out to be a busy day. I’d like to answer your question in a more general way instead of responding to specific questions. The overall goal of ACT is to help us learn how to “do nothing.” But to get to that point, first we have to deal with our anxiety and fears. Guy Meadows calls this process “getting to know our insomnia.” This means getting to know all the negative thoughts, emotions and sensations that are associated with our insomnia instead of running away from them. That’s why we stay in bed. As we get to know them, we then start practicing techniques to neutralize them. This is the “Welcoming” part of ACT where we do things such as “playing” with the fears, having compassion for our fearful parts, and having a sense of humor towards them so that we don’t take our fears so seriously. They are just fears and they can’t hurt us. Most of the folks here on this thread have all gone through this process. This part of ACT therapy is not easy, but essential. In the book Guy Meadows talks about Carlos who had a few really difficult, long nights in the beginning as he was getting to know his insomnia.

Once we start getting the knack of the techniques and the negative thoughts, fears and sensations start losing their power over us then the next step is “Acceptance.” This means total acceptance of the possibility of a sleepless night instead of struggling with it. When we can really get to this place of total acceptance without any expectation of sleep and just lie there in bed resting and “doing nothing,” then lo and behold, we fall asleep! This is because the mind finally gets out of the way and our body takes over. Since my recovery this has hit home as I’ve seen how when I wake up in the morning and think about the night before, I have absolutely no idea how I fell asleep. It just happened! I had absolutely no control over it.

I guess I wanted to answer your questions in this way so that you could see how ACT takes a fundamentally different approach to insomnia than CBT-I. With ACT you develop a different “relationship” with your insomnia, where you’re not concerned about any rules but only about learning to “do nothing” so that you naturally fall asleep.

[Deb]

Steve – I’m glad you had a better night through preparing ahead of time to accept whatever happens instead of getting frustrated with it. That’s great! About my medication, I’ve only missed two pills so I don’t think this is causing the relapse. As a precaution though, I’ve decided not get off the medication just yet.

It’s really not a complete relapse because I’ve basically been sleeping. It’s just the anxiety about insomnia crept back. But I’m going back to accepting whatever happens again and hopefully the anxiety will go away.

Thank you, Gdsman. Yes, it’s normal to feel fear of insomnia. It was definitely one of the hardest thing I’ve gone through in a long time. I wouldn’t wish it on my worst enemy. But I felt reassured by Guy’s statement that over time the fear will subside as we gain confidence that we can recover from relapses through using the techniques. Gdsman – glad your sleep is getting better too. Too bad about all those creeping things in your house! That would certainly keep me awake!

[Steve]

Mac – Remember that ACT doesn’t really do SR. At least not a strict one like you are used to. At most, after estimating how much sleep you need, you can reduce that by a half hour on each end, but it’s not a requirement. If you can’t sleep, you stay in bed and the next night, you go to bed at the same time. You don’t reduce the SW. Also, you go to bed at the same time every night (unless you are out with friends or some such) and get up at roughly the same time every day. You can stay in bed for a half hour to an hour before you get out of bed like, say, on a weekend. A lot of the principles of ACT are not compatible with CBT-i, such as SC and going to bed only when sleepy. That’s why we tell you that you have to jump in all the way and don’t do both.

Well, my sleep is all over the board. Last night I woke up again an hour after falling asleep. This time though, I stayed awake and couldn’t get back to sleep. I was all ready for it to be an hour’s sleep night and I was accepting of that. But I did fall asleep for between another hour to an hour and a half around 3:00 in the morning. Surprisingly, I don’t feel that bad this morning. I have slacked off on doing the meditations but have started up again in earnest the last two days so hopefully that will help. I am also starting to live my life again no matter how bad I feel. On Sunday, I went over to a friend’s house to watch a football game. Monday I went to a disaster preparedness meeting put on by the National Guard at our local library. And Tuesday night was the gym. Last night I just did some household chores but tonight I will probably be back at the gym. I found I can do my breathing exercises while running on the treadmill. My trouble is my body starts out well on these programs but then it seems to adjust. As an example, I started out well on CBT-i and worked myself up to around 5 hours of sleep. Then I regressed back to getting only 2 to 3 hours of sleep. I started ACT and got up to a good level then started regressing again. Then I started the CPAP machine and for a week or two got up to getting between 6 and 7 hours of sleep and now I regressed again to where I am all over the board. I just have to keep doing the meditations and using the tools. I also have to get out more and live my life instead of staying home and falling to insomnia. That’s the only way I am going to beat this. And I know it will take awhile. In that last chapter that Deb mentions in the case study, it took that woman around 6 months.

[Author]

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