[jessallie]

I keep hearing making mention of Cognitive Behavioral Therapy for insomia all the time but I've never been able to find a real explanation of what exactly it really is and what you are supposed to be doing. I have heard mention it's a way of changing your thoughts about things, but that's as far as it goes. I see it mentioned in passing all the time but no details on how you are supposed to change your thoughts and why this would help. I also don't understand how changing your attitude or thoughts would make you able to sleep when you wake up in the middle of the night and your body feels like you are jumping out of your skin.

Is it just sleep hygiene?

Is it relaxtion techniques?

Is it meditation?

I hope not, because, been there, done that.

Can anyone give me the low-down?

[owl2020]

I have been using aspects of CBT in dealing with my insomnia. Basically CBT calls for changed behaviors that enhance your ability to sleep. This means sleeping only within certain times so you have regular sleep hours, using the bed for sleep and sex only, eliminating bedroom distractions, going to bed only when sleepy, don't lie in bed if you can't sleep – get up and do something, get enough exercise, get sunlight, etc. It has helped to an extent but it has its limitations. For example, it is nice to say go to bed only when sleepy, but last night I didn't feel sleepy in my normal “sleep block” and couldn't get to sleep no matter what – an awful night. I'm sure there are others who can explain it better, but basically it involves behavioral and attitude changes. Just out of curiosity, how are you dealing with your insomnia presently?

[Martin Reed]

Here's a good starting point (be sure to also check out the source link):

http://www.insomnialand.com/blog/free-cognitive-behavioral-therapy-techniques-for-insomnia/

You're basically on the money – it's a combination of sleep hygiene and changing the way you think about (and approach) sleep.

Owl2020 gives a good overview (thanks). It would be good if any other members who have tried CBT (either professionally or 'Do It Yourself' style') can chime in here, too:

* What are the components of CBT?

* Did CBT work for you? If so, which parts?

Any other thoughts or experiences related to CBT would also be helpful – not just for jessallie, but for all Insomnia Land members.

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[Tired Ted]

Well here I am awake after going to bed ( and sleep ) early ( c 8 pm ) but at least I have got almost 4 hours in my sleep bank . . . my problem appears to be ” being in bed ” and I seem to sleep much better on the sofa. I have now realised that this is because I cannot lay on my stomach on the sofa . . . my favorite sleeping position and the one I end up in when in bed, no matter how hard I try, or what I put in place ( tried and tried putting pillows between knees and around my body but the pillow fairies always seem to manage to move them !! ) I have a back problem and have realised that it is aggravated after laying on my stomach as this position causes aches from the top of my shoulders to the base of my spine and this ( along with my very weak menopawsal bladder ) wakes me up throughout the night and I am currently having a little blip getting back to sleep becase of the old aches and pains.

I used to get very het up and frustrated about being an insomniac because it wasn't ” the norm ” but thanks to the invaluable advice from this website and Martin / subconscious DIY CBT from myself and great support from my insomniac buddy Grogz I found a way to accept insomnia and I now class my insomnia as ” my norm “. This revalation took the immense pressure and frustration out of the nightmare that was my insomnia. I made the conscious decision to look at and tackle insomnia from a differnet angle and created my own little sleep bank that I topped up each night and as long as I got the required number of hours sleep that I ” personally ” needed to function ( no matter how many times I woke up during the night ) I was fine. I used to plan special interesting projects to do in the wee small hours when I woke up and in the end I found my creative side and even looked forward to my early doors sessions, sewing, knitting, pampering myself et al . . . I even baked and decorated my own wedding cake . . . I didn't intend doing my own cake but this was a lovely way to pass away the long dark hours and it was gorgeous. I have to say sewing away on the sewing machine early doors didn't work quite so well for my new husband . . . hence taking up the much quieter pastime of knitting !

Mind over matter won't work for everyone and I have to say that I am the last person I would have said it would have worked for but it has certainly made my insomnia soooo much easier to live with and I have to say that learning to live with insomnia has made me a much more positive person. My glass became truly half full once I found a positive to come out of ” my ” insomnia and historically my glass only ever had a splash in it . . . I couldn't even see the half empty bit some days as I was a pre-programmed pessimist !

I hope everyone gets at lest some rest tonight . . . whatever and whenever ” your ” tonight is

Tired Ted, who is just about to do a relaxing session in the hope of getting some more big ZZZZZ's in the bank sortly x

[jessallie]

It does sound to me like sleep hygiene. I fall asleep fine so I believe I'm doing what I am supposed to. I wake up about an hour and a half later and I'm up until I take something., and then again up at about 3:00 AM. Both times I am hyperactive. I cannot sit and read or do a crossword. I feel energized as though I had a great nap and I am ready to start the day. Unfortunately, if I remain awake, the rest of my day is ruined because I am so tired from broken or lack of sleep. I have been alternating sleep remedies (to keep from getting used to anything) that I have on hand, anything from prescription, to homeopathic, to benedryl. I often try relaxation, white noise, meditation, and binaral beat cd's. But those don't work more than a few times before they lose effectiveness. Not living alone, I hate to get up and have to be quiet and cold and in the dark. I would love to be able to get things accomplished while I'm up but it's just not feasible without waking up the house and I'm too wound up to sit quietly. I wish I could function with less sleep but I feel misterable the next day, and I feel myself nodding off all over the place.

[Tired Ted]

Hi Jessallie

Boy I don't envy you those 3.00 am wake ups . . . 3.00 am was like Groundhog Day to me . . . I could have set my clock by it until I took Martin's advice and turned the clock around so I couldn't see it !

Have you signed up for Martins free sleep program . . . sorry can't remember what it is called now, or if it is still available but it really did help me come to terms with insomnia and lose the frustration about it. A few of the best bits of advice for me where turning the clock around and not looking at it when you wake up . . . as Martin guided, if you have your alarm set to wake you up in time for work ( or whatever you need to be up for ) it really doesn't matter what time it is when you wake up and as I know only toooo well with my 3.00 o'clock . . . looking at the time and seeing how long ( or how little ) you have left in bed can add to the viscious cycle that is insomnia. Some other great tips were keep the room dark and cool / use the bed for sleep and s*x only ( ie no reading, or other ” non bedroom ” activies to pass the awake time ) and don't try too hard to get to sleep as the harder you try the less chance you will have of actually getting to sleep ( hence my activity plan ). One night when I had to get up I started to write a list of pleasurable activities I could do in the middle of the night when I got up . . . one of the downsides of the menopaws ( I know I have spelt it incorrectly but it looks and feels less AGGRESSIVE spelt this way ! ) is that you can't remember a thing from one moment to the next . . . I now ( well when I remember ) call it Sometimer-paws because sometimes I remember and most times I don't !!

Another of Martin's great tips was don't just lay there, get up and go back to bed when you feel tired again. I can't think of the other things which changed my insmniatic world at the moment . . . I am struggling to keep my eyes open . . . . another thing I dislike about insomnia . . . you can spend soooo long trying to get to sleep and then struggle to keep your eyes open when it is time to get up !

I was very lucky when I was having real problems with insomnia to find Groggy on here and she was going through similar things to me and we helped each other through insomnia . . . if you look at my profile and for my previous posts you will find the topic Groggy set up and our conversations ( I am sure it will be of no surprise when I tell you I can't remember the title of the topic ! ) . . . that will keep you entertained and amused in the wee small hours as it goes on for pages and pages and it is just conversations between Groggy and I but you may find some of them useful. We did tend to go ” off piste ” at times ( probably explaines why not many others on this forum joined in our conversations ! ) but I am sure there will be lots of information in our conversations that may help. Rather than thinking of being miserable in the cold and dark why not get a nice snuggly pair of PJ's and bed socks like I did for the wee small hours . . . I even got a bed jacket when it was very cold here in January !!! I used to sit up with a big mug of hot chocolate and before I knew it I was looking forward to getting up and being creative. I know you are feeling hyperactive when you get up at the moment but I think that is probably frustration at having to get up because you are awake and having to keep the noise down for others in the house. My husband is a very light sleeper and even putting the TV on could wake him up but I soon learn't to tune into the turned down TV. Accepting and living your life around insomnia is unfortunately a slow process and it doesn't happen over night but it can be done ( hopefully ). . . as I said earlier I am amazed that I managed to learn to live quite happily with it and it was an even bigger surprise to Groggy who was adamant that it would never happen for her after decades of not sleeping and it really did . . .

I am not ” fixed ” by any stretch of the imagination . . . as I starting my reply after I woke up a little disappointed early doors will testify ( I found insomnia much easier to live with once I downgraded frustration to disappointment ! ) but I do know and appreciate that I am one of the lucky insomniacs who has found a coping strategy that works for me and I really hope you can too.

Tired Ted who has woken up all achy after laying on her stomach again . . . at least I did get some really BIG ZZZ's and my sleep bank is fully loaded for another day !!!!!

PS – I found the ” Solfeggio 639 Hz ” relaxing app and downloaded it to my iPad and this really helped m

[owl2020]

I am more like Jessallie in that I feel really awful and depressed the next day if I don't get enough sleep. After a two hour sleep night the previous night, I am OK today because I got about 5 1/2 hours sleep last night (very good for me). I have tried a number of things to get to sleep, when it seems I can't or when I wake up too soon – sleeptracks, walking around the room a number of times, reading, even cleaning in the kitchen once but none of these help much. It almost seems like there are nights I'm destined not to sleep much (if at all). The only medication I have used, is the over-the-counter sleep aide Unasom, but I have found it lost it's effectiveness fairly quickly; I rarely use it now – it only gives about 2 hours sleep these days. I find that walking a lot during the day helps tire me out, I don't go to sleep until a certain set time, and I try to eat foods that help with sleep. However, it just seems if I don't feel sleepy a particular night there is not much I can do about it. More power to those who can adjust to their insomnia, but all I can do now is be thankful for nights when I get a decent amount of sleep – I dread the little or no sleep nights and the aftermath the next day.

[jessallie]

I have literally two bedside draws full of cd programs for sleep. All of them work temporarily and then stop suddenly and never work again. (That's why I kept buying more). Right now, I can't even entertain the thought of buying yet another one. The only one that continually works is “I can make you sleep” by Paul Mckenna. Unfortunately, even his, doesn't get me through the night. So sometimes when I wake up in the middle of the night, I listen to that. It gets me to sleep but wake up again an hour later. I'm beginning to think I wake up hyperactive after dreaming. Theta state, perhaps? I think I am cycling and waking up at a certain period in parts of my sleep cycle. I'm wound up like a clock (no pun intended). My body will not lie still without feeling caged and uncomfortable, yet my mind is tired. Weird, isn't it? I am very active. Exercise every day. During the day I get a second wind and then I get exhausted. Vicious cycle I cannot break. The only thing that works for me is timed released ambien, but I only take it when I absolutely cannot go another night without more than three hours straight sleep. My body gets used to things very easily no matter what it is. Too bad it can't get used to sleeping.

[Helen]

I've tried mindfulness which is a type of CBT. Unfortunately it didn't help my insomnia. Any relaxation track that I've tried in the past hasn't helped. At the moment I'm reading Paul Mckenna's 'I can Make You Sleep'. I haven't tried the CD yet, but I will and will report back.

[owl2020]

I find also with sleep CDs that they may help you get a little sleep but don't get you through the night. I also exercise a lot by walking, but basically I wait for the “sleep deficit” to build up to my regular sleep time in order to get a night with 4 or 5 hours sleep. I live for that, but it is not a sustainable way to live over the long term so for now I just live from day to day and try to hang on to life.

Jessallie mentions time release Ambien as a last resort she uses that gets her through the night. I was wondering how long you have been using it, since someone claimed elsewhere that Ambien loses it's effectiveness after 4- 6 weeks but I have heard of other people using it for a year or more. How long have you been using it?

[Helen]

I'm using Ambien (Zolpidem) 10mg since March. I was on a lower dose last year and had a period of 3 months when I was sleeping ok without medication (although waking about 4 am). My GP says it loses its effectiveness. I try to do without it, but end up taking one every night, but at the moment don't have any choice.

[owl2020]

Last night I got about 3 1/4 to 3 1/2 hours sleep in one block – I would have liked at least 4 hours. As I have indicated earlier I have used some aspects of CBT, like keeping a set time to go to bed, exercise, get sunlight, cool dark bedroom, no TV or computer use in the bedroom after dark, etc. I also eat foods that help sleep. So CBT techniques help but only to a certain extent; some nights you do everything right and you still can't sleep or get enough. The problem with the various sleeping pills is that they gradually lose their effectiveness. Helen if you have been taking Ambien since March, I would have to assume it has worked for 3 to 4 months so far (not clear if you are using the time release or non-time release version). I wonder how much sleep you get from it on the average. You know it will gradually lose it's effectiveness but feel you have no choice. When it loses its effectiveness, I guess you will look for another type of pill (and hope it works) or deal with insomnia without pills – not an easy thing to do. So CBT techniques are good but don't work 100% for everyone. Sleeping pills can help for awhile but lose effectiveness over time. “Sleep” CDs help some people to a limited extent, but it seems to me rarely get you through a night on a consistent basis. Melatonin and “sleep cocktail” products containing melatonin seem to have limited effect if any. So a lot of us are stranded with insomnia to varying degrees; continual lack of adequate sleep is a serious health issue. How many heart attacks, strokes, suicides, etc. really go back to insomnia? The medical profession and the media don't take this issue seriously enough.

[jessallie]

I never use any sleep aid more than 2 nights in a row, because they all lose effectiveness. I alternate herbal, over the counter, homeopathic and presciption sonata, ambien, or bentyl. They all keep me asleep in varying degrees. I have it down to almost a science now. “If I wake up at 2:00,I take this… If I wake up at 4:00, I take that…. ” Or, I try to wait it out. Melatonin actually makes my insomnia worse, but everything I've been reading states all these melatonin supplements are too strong. You don't need so much melatonin. I think they recommend less than 1mg. I've had success with Dried Tart Cherries mentioned on Dr. Oz (or they recommend the juice , but I don't want to drink 8 ounces of anything before bed.) That has worked but not all the time. It's supposed to have natural melatonin.

[owl2020]

Jessallie you really have a complex balancing act – I guess insomniacs have to develop complex strategies to get adequate sleep. The problem, as you state, is that all these pills and liquid solutions lose effectiveness over time. I've heard a lot about Tart Cherries lately and have started taking Tart Cherry capsules from Swanson Health Products called “HiActivesTartCherry”; too early to know if it helps or if there are any negative side effects (one capsule per night, 465 mg of tart cherry powder). I also drink a small glass of Tart Cherry Juice about 4 hours before bedtime, but I can't drink a big glass closer to bedtime because I would be up urinating all night. I also eat some canned tart cherries closer to bedtime but I haven't tried or seen the Dried Tart Cherries you mention – I'll have to look around. I also eat some almonds closer to bedtime. Will all this make a difference with sleep – who knows? Apparently it has helped you sometime. Don't know what experience others may have had.

[Author]

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