[Manfred]

I have another setback – and my intesive sleep anxiety is back.

After sleeping for several weeks very well, I had one bad night and that brought the whole thing back.

I was triggered by me enacting my (violent) dream. I don’t know if this REM disorder, that I rarely have, is triggerd by the anti-depressant I take for years, is part of my “rhytmic movement disorder” (since a child, I roll my head/body during sleep) or – and that frightens me a lot – is a disorder on its own since it is often a precursor to Parkinson. Need to go to a sleep lab, but due to Covid-19, everything is closed here right now.

My sleep anxiety has an obsessive part. And I fear “losing it”. It is a mixture of intrusive thoughts, ruminating, adrenaline rush…

After two bad nights with lots of anxiety (also during the day), I re-started CBT-I last night. Cut my sleep window to 5,5 hours. I fell immediately asleep and slep around 5 hours.

But my anxiety keeps “hunting” me. I think it is “fear of the fear”, the fear that the anxiety is stronger than me and won’t let me sleep.

I know ACT and the Sleep Book. I have meditated in the past. The whole thing is very difficult for me.

Does anybody here know and tried the “DARE Response” (book and app). I like it alot, the principles are quite similar.

How do those of you with intensive sleep anxiety, cope? What do you do exactly when anxiety hits? How do you prevent it? Do you take a benzo to bring anxiety under control?

I could really need some advice.

Thanks in advance, stay healhy and … sleep well!

Manfred

[Mac0908]

Sorry to hear about this rather bad setback, Manfred. The first thing you should know is, at least from my experience and seemingly many others is, with regards insomnia, when it rains it pours. This means that when you have a bad night, more times than not it means you’re going to have a few bad nights, or sometimes even enter a new flat out bad PHASE, before your nerves eventually calm back down and you get to sleeping better again. I don’t even consider these “relapses” but more of just part of the up and down process that is chronic insomnia recovery.

The hope is that as you continue to get past these bad nights/phases, your sleep confidence will improve more and more until your good nights/phases are outweighing the bad. I’m really not sure where you are at in your recovery process (maybe you can sum it up for me), but if you’ve been dealing with this for long time then by no means do I think you should be implementing CBT-I after just two bad nights. Instead I think ACT is the right form of approach for something so short. Now if it were two bad WEEKS, thats another story.

Deb, how are you doing these days? I myself actually had a few rough nights these last few days, ironically starting it seems right after I gave you my good update. Nothing more than what Manfred is pretty much dealing with. I had one rough night, and now it’s spiraled a bit, though Saturday I did sleep well. Last night however there was a unique circumstance where I went to bed in sweatpants which is something I rarely do on a count of 90% of the time I usually end up too hot. I felt however that it was chilly enough outside that it wasn’t going to be an issue. Wouldn’t you know it, at 4:15am I awoke basically sweating. Took the pants off, but was never really able to fall back asleep. Especially with my 7am alarm coming up for work from home.

Just sad sometimes to think about how, years ago, or when I was a teen, whatever, if this ever happened I’d wake up, get rid of the pants, and fall back asleep within minutes probably. But these days I’m a changed sleeper unfortunately. Anxiety is still there at times. Nothing like it used to be in years passed, and yes I’ve improved greatly over the course of the last year, but, the sleep anxiety still comes out at times, last night an example.

Well I hope that tonight is the start of heading back into a good phase. I don’t know why but sometimes After a period of bad nights like I’ve just had, one day I’ll just have a *feeling* that I’ve had enough now, and I’ll likely be coming out of it.

Deb how are you doing over the last week?

[Deb]

Hi Mac – I’m doing well, usually falling asleep between 10-20 minutes. Back to normal. Sorry about your bad nights. One of my relapses also started when I got too hot one night. I’ve found that we’re still recovering or our recovery is still fragile, we have to avoid things that might keep us up or wake us at night, even though before it was no problem.

Sounds like good advice for Manfred. Manfred – ACT is not just about meditating. If I were you I would re-read the sections on Mindfulness and Welcoming. These are both techniques to calm anxiety. If medication helps, go ahead with that too. Somehow you have to deal with the anxiety directly or it will keep coming back. Mac – it sounds like you’re getting a handle on that. You accept that some rough nights will come and then just let them run their course until you get calmer again. Maybe this would help you too Manfred.

Steve – you’ve dealt with a lot of anxiety also. Any advice for Manfred? Maybe you could share how you practiced ACT and calmed down your anxiety.

[gsdmom]

Manfred – Sorry about your setback. I keep having them too. At night I try to do the “welcoming” of fears and thoughts I am having. I try to release my control and fears to a higher power and trust things will improve. Sometimes it might take several hours for me to calm down, and maybe sleep for 3-4 hours, sometimes not at all. I find if I really look deep and put a name on what is bothering me that is helpful. Most nights I feel very calm just before bed, but I am probably focusing on sleeping too much, just enough mental process to keep me from drifting off. Lately, I might have 3 good nights or 3 good weeks in a row, and then no or minimal sleep for several nights in a row. So Frustrating!!!

I have never taken a benzo, but do take Ambien more often than I’d like. When I was not working I went for about 10 weeks without an Ambien. I’ve tried to reduce my dosage at least and lately take only 2.5mg, instead of 5mg. And if I don’t sleep on that, then so be it. I often feel in conflict about taking medication and getting some restorative sleep vs taking no medication but doing harm by not getting enough restorative sleep.

[gsdmom]

Mac – hope you get back to sleeping well, and can’t wait to read about how your dark under eye circles have disappeared!

Deb – glad you are resting well too!

[Manfred]

Mac, Deb and gsdmom – thank you very much for kind words and your advice.

With ACT or – I like it a lot: The DARE RESPONSE – it comes all down to the same thing: NOT RESISTING the fear, accept it aso. I think this IS the thing to learn.

I am a big fan of sleep restriction (SC is another thing though…). Although it adds pressure (knowing you have only 5,5 h for sleep, adds pressure); here the “not resitsing” part comes into play.

I need to work on a deeper level with this anxiety (and intrusive thoughts). As written in “DARE”, I think it is the fear of the fear, the FEAR what the FEAR could do to me, that is what keeps fueling the anxiety.

Right now, I am reading “Feel the fear.. and do it anyway”. Seems to be very good, with clear exercises to work with your anxiety (the author states the same: the deepest level (level 3) of every anxiety lies “I can’t handle it”. That’s it! She offers precise exercise (I am still reading the book), for ex. positive self-affirmations).

It is good to know not to be alone here.

Stay seafe and healthy.

Manfred

[Steve]

Hi Manfred. Sorry to hear your having so much trouble. The best thing I could say is to keep practicing the tools as described in the ACT book. And also to remember that relapses will definitely come. But just keep practicing and the bad times will be less and less frequent. I still have them and as Mac said, they seem to come in bunches. Once you get a bad night, you’ll probably get a couple in a row until your mind learns to deal with the anxiety again. I also want to say that you need to pick either CBT-i or ACT and then stick with that method. It isn’t wise to do both. I believe Deb will agree with me on that.

[Deb]

Yes, Steve, I agree with you. Manfred, as long as you have a reasonable sleep window you should be fine. The focus is on learning to relax about sleep and not on building up your sleep drive.

Steve – How about sharing how you practiced “Welcoming” and dealt with your fears. You were good at using humor to subdue the fears and you had some good examples. For myself, when I would feel fear, my stomach on the left side would tense up. So I imagined that tension as a little guy who was a furry red ball and who was so worried. I named him Mr. Worry Wart. When I imagined him in this way, then I felt sorry for him and the fear melted away. Gdsmom, you had some good examples also of taming your fear using “Welcoming”. I think these examples would be helpful to Manfred.

[RonA]

GSDmom, I see you are taking ambien while practicing ACT. I have done the same and I think it may be the biggest contributor to my latest setback. Using a pill when you know you are going to have a bad nights sleep is a great crutch but I fear my brain has not learned to do it itself anymore. I have been using Xanax 1-2 nights a week but am think I need to stop that practice if I ever hope to get long term better.

Has anyone else here had a similar experience with meds while practicing ACT?

[Deb]

Hi Ron. Whenever I practiced ACT I would always completely give up taking Ambien, because I knew that by doing so I was training my brain to depend on it to sleep. Martin talks about this too in one of his videos. He says that the worst time to take a sleeping pill is when you’re frustrated about not being able to sleep, because you are reinforcing the association between the pill and sleep. So I would go completely cold turkey. If I couldn’t sleep I would just accept it, and over time my sleep got better. I was determined to remember how to sleep naturally which I did.

[gsdmom]

Hi RonA – The longest I was able to stop Ambien was for about 10 weeks since I started it last year. Prior to insomnia it had been over 8 years since I took anything for sleep. I started taking Ambien again the end of November, probably due to holiday and work stress. The most I take it 3x a week. If I knew I was having a bad night but didn’t have to work the following day, then I’d skip the Ambien. Since I started ACT back in August, there have been two periods where I was almost normal – getting good sleep for almost 3 weeks in a row. That happened in Nov. and March. I’ve never taken Xanax. Many years ago I had ativan/lorazapam, it relaxed me but never got me to sleep, even taking narcotics didn’t put me to sleep (neck injury, not for sleep). Ambien is the only thing that ever worked. Last week my employer reduced staffing by 2/3, and only the most experienced stayed on (which wasn’t me) so I’m hoping over the next few days that my sleep will improve if I can just keep my household mellow.

I hope that you are at least feeling a little more refreshed and getting more restorative compared to last summer. I am, thank goodness.

[Steve]

Manfred – Basically, all I did was to have some kind of icon represent each of my fears. As an example, I was always questioning why the insomnia started and I was coming up with all of these scientific explanations. So I would have a guy in a trench coat carrying around a magnifying glass representing him. (Looked a lot like Peter Falk from Columbo.) Anyway, after I welcomed all of these characters, we would just get into a group and laugh and dance and just have a good time with each other. This really only took a couple minutes at night before bed. That’s how I learned to face my fears. It took awhile but I don’t have a lot of my fears anymore. I still have the insomnia but that’s just because of ingrained anxiety that I still have to conquer. (That’s one of my fears that I still greet at night before I go to bed and when I wake up in the middle of the night.)

[Steve]

RonA – There is another reason to stop taking Xanax. It is a benzo class drug and they are HIGHLY addictive. Have you ever had to increase your dosage in order for it to work? If you have, you could have developed a tolerance to it and you’ll need to watch very carefully how you come off of it. You may want to check with your doctor before you stop. I’m not trying to scare you but rather caution you.

[RonA]

GSdMom. I improved quite a bit from last summer which I remember was a nightmare for both of us. However, while I slept better, I was never “cured”. Every night was a battle and too many nights I resorted to taking a pill after waking up and I kind of stumbled through 2019. Earlier this year, my sleep started regressing again and I started experienced pretty severe sleep maintenance insomnia. I would only sleep 3-4 hours a night unless I took a xanax when I woke up and then I slept a full 6-7 hours. I have started suspected that the problem was the xanax and that my brain was associating the ability to fall back to sleep with needing a pill. I have resolved to not doing that anymore and had a string of really bad 2-3 hour nights earlier this week. Last night I slept better so I have my fingers crossed.

I am really glad you are doing better!!!

[RonA]

Steve, I have been sort of lucky with the xanax. I only take the smallest dose which is .25mg and sometimes even just 1/2 that and it always works for me. As you mention, I am concerned about benzo addiction so I have only used it intermittedly and thought I was ok. As you can see from my previous post to GSDmom, I think my part time use has caught up to me too!

[Author]

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