[NM]

I started experiencing very bad insomnia about a month ago. I had a few nights of zero sleep and started to have a lot of anxiety about my sleep because I’m starting treatment for a health condition and know lack of sleep will only impact this process and success negatively. My sleep anxiety and anxiety in general is I think my number one issue as well as now having extreme hyperarousal when sleeping or about sleep. I read about CBT-I and started implementing the techniques but now have found my sleep is so much worse and I feel like CBT-I has trained me to be even a worse sleeper and pay so much attention to sleep. For example I have anxiety about not falling asleep and getting out of bed for stimulus control so I’m paying attention to falling asleep and it’s increasing my anxiety and making it hard to fall asleep. Also now when I wake up no matter what time it is I can’t fall back asleep because of the hyperarousal and being like “okay did I go back to sleep yet? nope, I better get out of bed for the day so I have sleep drive tonight”. Also with sleep restriction I do sleep every third night pretty well after two nights of only sleeping 1-3 hours but I feel like I’m training my body to learn to only sleep deep every three nights and feel awful physically the other two days. I’m kind of freaking out about CBT-I and the overall negative impact it’s had on my sleep. Maybe I need to treat the anxiety first?

[Martin Reed]

Welcome to the forum, NM! How long have you been implementing cognitive behavioral therapy for insomnia (CBT-I) techniques? It’s not unusual for sleep to temporarily get worse as you adjust to the new routine and techniques — but this doesn’t usually stick around for long.

When you are in bed awake, does that feel good? If not, might it be a more appealing alternative to get out of bed and do something relaxing and enjoyable (that does help you feel good) instead? Not only are you giving yourself the opportunity to feel good, but getting out of bed prevents you from reinforcing a negative association between your bed and unpleasant wakefulness — and you’re continuing to build sleep drive.

It’s important to recognize that you aren’t depriving yourself of sleep when you get out of bed, because you aren’t asleep anyway. All you are doing is shifting unpleasant wakefulness out of bed and giving yourself the opportunity to do something other than struggle with sleep.

How long is your current sleep window? You are already experiencing the power of sleep drive because you have found that after a couple of nights of little sleep, you are getting a nice chunk of catchup sleep. So, depending on how long you’ve been following your sleep window, it might be worth continuing with it for a bit longer.

I hope this helps.

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The content of this post 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. All content is provided “as is” and without warranties, either express or implied.

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