[AFriend]

Hi,
I have had severe insomnia for 3 years. I tried several courses of CBT-I, medication etc etc. I developed anxiety at bedtime, anxiety about not sleeping and how that would affect me long-term. It was a viscious circle of anxiety feeding on itself. It got steadily worse, some bad bouts with no sleep for days on end.
I did Martin’s free course and I improved a lot within a week or so. After about a month or so I slipped back into the same pattern of anxiety at bedtime, lying in bed waiting to go to sleep.Eventually, I’d feel anxious most of the day as well. I started Martin’s 8 week online course when I was at a really low point and during the course I improved but had a bad insomnia bout around week 4. Martin was brilliant in supporting me through that. Listening to Martin’s audios, doing the meditations etc helped me to look at the whole sleep issue in a more informed way and helped me to feel less anxious. To deal with my anxiety he suggested Barry McDonagh’s DARE technique, it’s for people with panic attacks which is not me, but the technique has helped me deal with the medium-level anxiety at bedtime which doesn’t sound as bad as a panic attack but it’s anxiety that’s still high enough to keep me awake all night, making it a blight on my life, So far, I’m into my second month of reasonably good sleep without major insomnia problems. For me, it was the two-pronged approach that helped – the sleep training with Martin and tackling my anxiety.

[Alice]

That’s great to hear. I have a question though: Whenever I tried sleep restriction I almost always failed to stay awake until my sleep window starts. Did you also have this problem? And how did you fix it? Also, if I did actually make it to the start of my sleep window, once I got into bed my sleepiness would be GONE and anxiety would start kicking in (and I never had problems getting to sleep, staying asleep was my problem). So for me, sleep restriction made my anxiety even worse..

[Anafernanda Barrera]

Hi Alice, so sorry you’re struggling with that. I am too but my issue was always falling asleep (and recently staying asleep too) when i went through this course two years ago, I recovered really well though it was not a clean breakthrough at all. There are all-nighters related to the anxiety of going to bed. Then i would break the rules and play by my own rules, then i would go back to the strict rigid rules and eventually it all just helped idk how…

[AFriend]

Hi Alice, I did do sleep restriction and that did help. For me I rarely had a problem falling asleep before the start of the sleep window although I might have been dog tired. I had developed a sleep phobia so that even if I was really sleepy, I was monitoring myself all the time, basically checking ‘Am I about to fall asleep?’ etc etc which kept me awake all the time. When I did Martin’s course, I did get anxious trying to observe the half-hour rule. That’s where you’re supposed to get out of bed if you haven’t fallen asleep within about half and hour, and do something enjoyable or something that helps disperse the anxiety for half and hour and then go back to bed, repeating as necessary. When Martin introduced that rule, I got more anxious lying in bed thinking…I’ve got to fall asleep within half and hour! He said, do whatever helps to reduce your anxiety rather than follow the rule if it makes the anxiety worse.
For me staying asleep has been more of a problem than getting to sleep, except when it was bad and both were problems.
I try to do things that support my sleep-wake cycle. Eg. walks in morning sunshine (not much of that in UK just now!) physical activity before 5pm, wind down from 9am onwards, eg. light reading, meditation etc., no computer or social media in the evening, dim the lights etc.. The most important thing for me has been to find ways of reducing anxiety and arousal around sleep because that is what prevents sleep coming on. I found Barry McDonagh’s book useful because it helped me to understand what underlies anxiety and how *not* to fight it which somehow makes it dissolve. Sorry if I haven’t answered your question directly.

[Anafernanda Barrera]

would anyone here want to exchange numbers? I’m going through a lot of the same things and by looks of it, talking it therapeutic for us otherwise we wouldnt be here sharing. I’m just going to go for it and leave mine here: 972-955-3863 (USA) i wish we had an in person support group because this is soo hard. I’m on a set back and spiraled with all the typical anxious spiral thoughts that come with a set back (including newly found panic attacks – yay!) If you can relate, please reach out.

[Martin Reed]

Thanks for dropping by to share your story, AFriend! It can definitely take time and quite a few ups and downs for us to build and strengthen our sleep confidence — and you continue to be successful because of your own efforts to implement behavioral techniques that build sleep drive and lower arousal while also exploring the thoughts and beliefs that can generate anxiety and make sleep more difficult.

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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.

[Manfred]

I think in the course of time, I have learnt “a thing or two” about (sleep) anxiety. Although I would not consider myself as beinng “fully recovered”, I am doing really well lately. So I want to adress this topic (my personal view) a bit.

1. @AFriend: it is not true, that the DARE approach is just for panic disorders. DARE goes to the core of any anxiety problem. There is the book, then is a fantastic (subscription-based) app with lots of short audios on the approach, various topics (also insomnia or intrusive thoughts) the “daily DARE”, guided meditations, success stories aso. There are also different subscrption plans with facebook support groups and three monthly video calls with Barry und Michelle Cavanaugh (they are both fantastic). U can also book 1:1 sessions. So an excellent for various needs.

2. I highly recommd to other books that go in the exact same direction:
– “Stopping the Noise in Your Head” – by Reid Wilson. It deals with Anxiety and OCD. Reid Wilson has also a website with an excellent (paid) online course.
– “Overcoming unwanted intrusive thoughts by Sally M. Winston

Of course, the “Sleep Book” by G. Meadows is great too. I really like the app “Sleep school” – there u learn to accept, observe and welcome sensations and thoughts around insomnia (imho works with every topci, since the principle is general).

3. ALL these approaches share the exact same contend: You have to observe, accept, welcome, yes even invite ur anxiety to stay. RESISTANCE (what we resist, persist) is the central problem. The only way OUT of it is THROUGH.

4. Never distract from your anxiety. Let it be, invite it to stay, observe it – or u can be even more aggressive and telling it to bring more (“is this all u have”)? And then ENGAGE in whatever u are doing (for ex. resting in bed).

5. CBT-I is a fantastic tool. Martin’s course is excellent. Sleep restriction is imho a key part, stimulus control if u need it (it makes to sense at all if u are way too frustrated while being in bed to stay there) – but I personally think it its better to learn to stay with ur anxiety until it subsides. Experiment with what works best for you.

6. To summarize: Some of us must work “hard” on the cognitive aspect of CBT-I. Just challenging ur thoughts or meditate is for many of us not enough. The approaches/books listed above (there are others) really go to the CORE of anxiety. It takes time and a lot of practice (setbacks will come and are to be expected). But “one day”, u will get it (the brain will be trained and rewired). In fact, it is more of an ATTITUDE than a technique.

The behavioral side helps tremendously (sleep restriction, unwinding, getting out of bed every morning the same time), but work hard on the cognitive side.

@Anafernanda: I am sorry to read u have a tough setback. I think u are the “ideal” candidate for the approaches I mentioned. Let me know if I can further help u a bit.

Merry Christmas to all – stay healthy!

Manfred

[Author]

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