[terryclem]

I am 84 year old guy and have developed fairly typical BPH over last 25 years or so.
Over recent decade this has resulted in need to urinate from 4 to 8 times a night (nocturia).
This can obviously be challenging to return to sleep after each awakening——especially
when adding “classic rumination type anxiety” into the mix! Without necessarily going into
the history of my probably atypical mental sensitivities—— my immediate question is this.
I assume most of us dealing with insomnia hope to reach a point wherein we might ideally eventually sleep through our night with maybe one or two visits to the bathroom. In my case,
I actually “need” to wake up and urinate the aforementioned 4 to 8 times for obvious reasons.
So, finding myself quite attracted to the possibilities of CBT i, I’m super curious how my
particular dilemma might be accommodated. It feels like it could be a disappointing
“deal breaker”. (BTW——My very able Urologist finds NO prostate issues other than
this frequency, which is apparently to be somewhat expected at my stage of life).

[Martin Reed]

I know we have communicated via email @terryclem, but for the benefit of others who might read this and be in a similar situation, CBT-I techniques aren’t intended to help with awakenings caused by nocturia. CBT-I also cannot make you fall back to sleep when you wake at night because sleep cannot be controlled in that way.

CBT-I aims to identify and tackle any behaviors and thought processes that might be perpetuating sleep disruption. These are typically behaviors such as allotting too much time for sleep, going to bed before sleepy, staying in bed later or getting out of bed at inconsistent times, tossing and turning all night trying to make sleep happen.

I don’t consider my work to be CBT-I — it definitely draws from some CBT-I techniques but in the years I have been coaching adults with insomnia I have found that CBT-I can trip a lot of people up as it can easily become a whole new list of rules and rituals that are implemented in an effort to make sleep happen, to avoid wakefulness, and to get rid of difficult thoughts and feelings.

With all this stuff, the more we try to control it, the more we tend to struggle with it.

So, when I work with clients, the goal is to move away from trying to make sleep happen and trying to control our thoughts and feelings (since none of that is within our control anyway). The goal is to act in a workable way — a way that moves you away from struggle and toward actions that help you live the kind of life you want to live, independently of sleep and even in the presence of difficult thoughts and feelings.

I hope there’s something useful here 🙂

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