[smith168]

Hello,

I have been employing SRT 2am-7am each night for about 4 weeks and am currently working with a CBT-I coach and have been for the past month. For some context, my sleep has been bad for over a decade and has systematically gotten worse and worse to terrible particularly in the last 3 years where i started entering the 5 hour zone, then 4 hour, and now i’m currently around 3-4 hours of sleep per night on average. I worked with this same CBT-I therapist since 7/2019 through 11/2019 and initially saw some relief after about 3-4 weeks of SRT and improved my average weekly sleep duration to 4.69 to around 5.89 or so hours on average about 2-3 months in. At the time i had a girlfriend and was coping with cigarettes, and modest to medium alcohol and marijuana relief; i broke up with the gf and then doubled down on the boozing efforts over the holidays and decided to save facing hard changes and life for the new year.
I discontinued sleep restriction from about 12/2019 through mid 1/2020 and resumed about 4 weeks ago or in mid 1/2020.

On 1/1/20 i quit drinking, cannibas, and nicotine, and have trimmed caffeine to maybe 3-4 times a week no more than a decaf and/or a diet soda before 2pm. In any event, my sleep if anything has gotten WORSE since beginning the SRT. I exercise A LOT and frequently, i don’t eat particularly great but i do supplemental with b vitamins, magnesium, vitamin c and d.

My problem is early morning wakening. I go to bed within 5-20 mins max, sleep about 3-4 hours tops, and then wake up and am in a miserable depressed mood where i can barely think and suffer from fatigue. I have started to employ cold showers in the morning and exposure to light – this hasn’t done much other than wake me up AT the time. It is so hard to stay up the last 2 hours before my 2 am bedtime and i frequently have microsleeps i can’t help… despite this, the moment i go to TRY to sleep now i am suddenly not nearly as sleepy, though i’m controlling anxiety, and try not to worry. I am ADHD (high functioning) and always have been -as info – so the mind is always going. In any event it has been 4 weeks and i’m still sleeping between 3-4 hours per night with good sleep efficiency but NEVER make it to my wake time and get up. I’m tired as hell all day and definitely right before bed, until actual bed where it takes about 10-25 mins to sleep some nights and will just wake up in 3 or 4.

It doesn’t appear SRT is working this round. Obviously i am very depressed that is destroying my life, i am in constant pain and worry, and get zero relief. What do i do? What is happening? Does it just need more time from cessation from booze/pot/cigs? I wasn’t a full blown pot head or alcoholic though i did smoke about a pack and a half a day (i did the patch and titrated to 0 nicotine 6 days ago), I am about ready to give up on SRT/Stimulus control as ITS NOT WORKING. What can i do besides waste everyones time with meds only to form dependence, habiutate, and face rebound insomnia, if i do???

Should i attempt to treat the ADHD via non stimulating medication so i can stop ruminating and the brain can get some sleep? Or treat the depression through low dose Zoloft? Or just robotocially clinincally and rigidly for the SRT that is NOT working?

• This topic was modified 4 years, 2 months ago by smith168.

[Deb]

Hi Smith – There’s another type of therapy that’s not very well known, called ACT. It’s based on learning to relax in bed so that sleep naturally comes. You learn to give up all control and stop struggling to sleep, just like normal sleepers do. I used it and was successful. For the best explanation of it, check out “The Sleep Book” by Dr. Guy Meadows who developed this program. You would have to learn to calm your mind in order for it to work, but the book has techniques for helping with this.

[smith168]

I’ve heard about it and probably need to read more on it but it seems to contradict CBT-I techniques and philosophy of being rigid and rather inflexible to force the body to learn anchor/wake time, force sleep drive, and force one out of bed if one can’t sleep. It seems simliar to what i was doing before – the old “Just don’t worry about it” technique…but what do i know? I need to read more. Sounds like i would have to choose one or the other CBT-I or ACT. Visualization, meditation, “thinking positive”, and even distraction so far hasn’t worked for my ADHD mind but i will look into it and i thank for your feedback and suggestion!

[Martin Reed]

How are you getting on since you first posted? Have you tried advancing your sleep window so it starts and ends a bit earlier? This might be helpful if you are (or have been) a bit of a morning lark since your body clock might be naturally inclined to send wake signals through your body in the early hours of the morning.

Since you are currently working with a therapist, I would encourage you to discuss your current concerns with them. Since they are far more familiar with your history and individual circumstances, they will be in the best position to advise, guide, and support you.

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