[Gabriel]

Hello

My question before the context: How do I overcome sleep anxiety of not being able to fall asleep naturally?

Context: Back in Sept 2020 I got covid-19 and about the second day into it, I began to have difficulty falling asleep later and later every day of the 9 days the covid symptoms. This led to sleep anxiety for the first time in life.

I’ve never thought about sleep before. Now it was taking over my thoughts throughout the day!

The month of Oct I had a week where I slept 1-2 hours for a week this led to trips to urgent care as I had no idea why my body was not falling asleep. Urgent care cooks t do anything except give me medication to calm me down and one nurse even scolding me and saying “you should see a therapist”. My mind didn’t know what to do! Did Covid affect something in my brain? I kept asking myself.

In November, this led to a path to primary doctor visits and subsequent medication for anxiety (busbar) and trazedone for “sleeping”. All the while trying using melatonin every night (10mg) and going down the road of supplements (ashwagandha, valarien, etc). Trying everything to make sleep happen. Needless to say the medication wasn’t working, the vitamins were hit or miss. I dropped the medication and focused on the supplements.

I even discovered CBT-I and tried to do it via a self-book but there was no difference.

December 2020, I began to work with an amazing therapist that helped me with manage this new anxiety during the day (something I never had before this) and constant negative automatic thoughts about not being able to fall asleep or staying asleep. I started all of the sleep rituals and steps that I found online to have a sleep hygiene. (1+ hr wind down, a coffee only in the morning, no phone screens, etc).

I am now in January 2021 and I had two good weeks of the month with sleep effort giving me 3-4 days of 4-5 hours and the other 3-4 days hit or miss 2-3 hours of sleep. The past 2 weeks I’ve switched supplements because the ones I was taking weren’t helping and past week has been brutal with 1-2 hours of sleep. It seems that I am back to square one.

I am seeing a sleep specialist in 4 days to see if there is anything biologically off, I don’t want to go back on medication, and tired of supplements.

I just can’t seem to fall asleep naturally. Where to start?

[Chee2308]

There’s nothing wrong with you. If you can sleep 3-4 hours, even just 1-2 hours means your sleep system is working perfectly fine. What you are describing is very typical for an insomniac. It’s your thoughts about sleep and the efforts you are doing that are making it worse. Do absolutely nothing except going to and getting out of bed the same time every day. Any endeavour you are doing to make sleep happen WILL fail because sleep just doesn’t respond to any type of effort, mental or physical. It is something that just happens naturally and your body produces sleepiness naturally, after being awake long enough. Sleep drive is a lot like hunger, both accumulate after not sleeping/eating long enough. Just go to bed after being awake for at least 18 hours continuously and if you find you fall asleep pretty fast, then start decreasing that to 17, 16 hours. Find the magic number that works for you because everyone is a bit different. Resist the temptation to try any sleep effort because after you done them, your mind will want to monitor the result, whether it’s working etc. It is this active monitoring inside your head that keeps you awake at night because your mind just can’t shut off. Stop all the monitoring and let your mind drift and wander as it wants, do not actively check whether you have fallen asleep, let it just happen naturally. You will find after sleeping better for few nights, you then tend to have diffficulty falling asleep again as fast as before. Expect this and accept this is normal because when you slept better, naturally your sleep drive is reduced and it then takes longer to drift off into sleep. But over time, your body will adjust so give it time and patience. Do these steps and your sleep should recover within a few weeks. Good luck!

[Gabriel]

Chee

Thank you so much for your reply. It’s very encouraging.

I’ve slept the 4-5 hours on great days since this all began. The problem has been not being able to fall asleep.

I’ve tried getting out of bed 20-30min of being in bed to read until sleepy but get worried once it gets to 4am – 5am and know that morning is coming and I didn’t sleep all night.

Not being able to fall asleep or stay asleep has been the biggest frustration.

Is trying the sleep restriction approach and just accepting that I won’t sleep all night the answer?

Thank you so much.

[Chee2308]

Hello Gabriel,
I am reading a lot of sleep efforts! Because you are constantly changing things, your mind is constantly monitoring for results and when something doesn’t work, you then get frustrated and that perpetuates the cycle of sleep disruption. From this point on, just do one thing only, whatever single thing you think is helping you the most and stick to it. If it doesn’t help then abandon it and do nothing! Sleep is not something you need to do a ton of things to achieve. It is natural and effortless. Did Covid mess with your head and “damage” something? Well nobody knows, not even the scientists so why should you even bother?? The problem is beyond you and has happened. So focus on the present and just do this one thing: Go and get out of bed at the same time every day. At first, allow a 6 hour sleep window with no naps and no sleeping in. Make this consistent for at least 2 weeks and your body should adjust to the new sleep window. If it is safe where you live, go out more in the morning to get sunshine because light plays a very big role in realigning your circadian rhythm and try to stay active throughout the day. One hour before bedtime, try doing something relaxing like having a warm shower, a nice cup of hot chocolate, watch your favourite tv series or anything you find enjoyable. Then go to bed with no expectations. Tell yourself you might sleep, which is great, or you might not, which is also okay because there will be endless opportunities for sleep in future. Either outcome is okay and you don’t really care anymore. Over time you become less attached to the outcome and you will begin to loosen your grip on trying to control sleep. Then when you are sleeping great for a week or 10 days or so, try adjusting your sleep window to allow more time in bed in 15 mins increments. Take note your body will react to this by waking up more or take onger to fall asleep because you are making adjustments and this automatically makes the mind start monitoring for results. Also, when you are sleeping more, the harder it will get for your body to fall asleep because you are no longer as sleep deprived as before. So expect all this to happen and there’s no surprise when you get a difficult night or two. But be consistent with any sleep window for at least 10 days to give time for your body to respond. If you find your sleep getting worse, then reduce time in bed and vice versa. Find that number that works for you where you can fall asleep pretty quickly and wake up not feeling as tired or groggy. Actually waking up a bit groggy is normal and everyone has it. It is also normal to feel sleepy during the day especially at midday where most people take naps. You should get back to how you were sleeping before when you implement these steps. Good luck and we all here are wishing you the best. Hopefully we’ll hear your success story in a few weeks!

• This reply was modified 3 years, 10 months ago by Chee2308.

[Gabriel]

This is all great feedback and encouragement.

I’ve researched sleep restriction times as you mentioned of 5.5-6 hours. Currently, after a relaxing wind down of an hour or so (I like to read books) I feel sleepy and get in bed around 11:30p-12:00am. My alarm clock is set currently to 7:15am. So that is about a 7 hour window.

Before all this, I was not a “morning person” so I would stay up later. So it makes more sense to adjust to a 12:30a-6:30a or 1:00a-7:00a to start?

Last night for example, I took advice from you and Martin from his videos and went to bed around 12:15a with clock set at 7:15a. I went to bed sleepy but I felt like I like my mind was awake. I got up and an hour passed. It was close to 1:30a. I took 2.5mg of Zolpidem to tell my mind that I need something to help me fall asleep. I was in and out every hour or so and after the 3rd or 4th wake up I looked over and it was 6:15. I put my head down again with my mind awake and the alarm turned on at 7:15a.

The in and out, mind racing, feeling of not actually sleeping, and thinking I am not fully sleeping. It’s the fear of “not sleeping the whole night” that is so strong. Is that normal to have during this time of sleep restriction?

[David1]

This is so similar to me but my problem started at the beginning of January. I had one sleep day four days ago that may have been as much as 7 hours, but split into 4-5 sleeps. Last 3 days have been around 2 hours.

I didn’t use anything last night or today for anxiety, and that is a first, at least since a couple of weeks ago. I too feel the drugs did little for me.

I’ve been venturing out more now, and today going for a massage. I suppose if I fall asleep during the massage it might be okay. Yesterday, I had a 45 min nap plus about 2 hours of sleep.

I know I am not the same as you, just glad to share and exchange ideas. Overall, I’m less afraid to do more, and striving for more normal daily activities. Walked 40 min today. Did some writing and singing, and now going for a massage.

[Chee2308]

Hello Gabriel!
Are you constantly checking the time when you wake? If so, please stop doing this immediately! Resist the temptation to look at the clock and trying to figure how much you slept. Clock watching is very anxiety producing for people with sleeping problems. So the only time you look at the clock is ideally one hour before bed, then settle into your one hour relaxation period before bedtime and then you don’t check the clock anymore. You then either go to bed because you start feeling sleepy, with heavy eyes/difficulty staying focused reading/watching tv OR you feel the time is right. After you gone to bed, do not check the clock when you are woken up. All you know is that the alarm hasn’t gone off and you just go back to bed and try to sleep if your body wants it. Go timeless. Monitor and check absolutely nothing.

[Gabriel]

Chee

Thanks for reply. I’ve been practicing the do not look at clock since October 2020 when trying to research sleep hygiene and applying it. The clock is on the other side of the bed and without my glasses I can’t see the clock.

I do use the Sleep Cycle app which monitors sleep during night and I quickly look at it in the morning when the alarm there goes off. This way I have a general sense of my wake up and if I get any deeper sleep.

Back to my last question. How did you handle the “fear of not sleeping the whole night”?

Especially after you haven’t fully fallen asleep as mind is keeping you up throughout night and you don’t have that feeling that you’ve fallen asleep?

[David1]

Good question. I’ve had 3 days in a row with 2 or less hours, wondering when I will finally have a night with more hours. I’m relatively calm about it and without drugs these last few days, but is this plan going to eventually start to work? The sleep drive will do its thing?

[Chee2308]

Hello Gabriel
I still am reading a lot of sleep monitoring going on! Using an app that supposedly tells you how you slept, what kind of sleep you got and whether you are getting any deep sleep etc, all of these are suggesting you are trying to control sleep which is impossible! Nobody can control sleep. After you’ve fallen asleep, your body does its thing just like digestion happens after eating your meals. Realise it is completely useless and futile to control or monitor your sleep simply because it is impossible and which serves no useful purpose either because it doesn’t help you to sleep well in the future. A complety pointless and aimless exercise. Like I said, less is more when it comes to sleep and absolutely nothing is best! With regards to your question about not sleeping the entire night, I realise the answer for me to get my sleep is this: Not sleeping. That’s the irony about sleep! Not sleeping (especially for longer periods) will get your body to fall asleep faster and deeper. Sleep is entirely self-regulating so letting go of complete control is key. Also if you go to youtube and look up a channel called Insomnia Insight hosted by a sleep coach called Daniel Erichsen, he talks about sleep as being a “gas and brake” model where gas is sleep drive and brake is a phenomenon called hyperarousal. Watch Insomnia Insight #356, the Bermuda Triangle effect will help you understand more about hyperarousal and how to reduce it. Good luck!

[Gabriel]

Chee.

Great perspective. I will also look into your suggestion.

Truth is, since all this craziness began I never monitored my sleep. Actually I downloaded that Sleep Cycle App in oct 2017 just to test out for a few days. I was sleeping “normally” then like I was my whole life. I checked the archive of the app and back then and I actually would go to bed at 12:00-12:30a and wake up at 6:00-6:30am for work and I was living a “normal” life.

This prompted me to say, hold on a minute what changed since then? The biggest thing that changed was the difficulty falling asleep and my mind seemingly active most of the night. Knowingly this is due to months now of the sleep anxiety and trying to find ways to “fix” myself to go to sleep.

The more I understand, accept, and am aware of this, I think is a step in the right direction.

Thank for your continued input
from your experience and success.

[Author]

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