[orellanoc]

My biggest sleep challenge is to actually fall asleep. Once I fall asleep, I can sleep throughout the night however, I cannot seem to fall asleep. The cause of my sleep issues was as a result of stress due to a difficult relationship about five (5) years ago and my sleep never came back to normal. When I went to study, I couldn’t cope with it and was prescribed Amitriptyline which has helped me tremendously however I am currently tapering off and due to this sometimes I don’t get a good night’s rest due to withdrawal symptoms. However, what has helped is because I tend to read up a lot about insomnia and tried to focus on what I have learnt about CBT and put those into practice (time for whining down, going to bed only when sleepy, get out of bed same time each morning even on weekends). I was browsing the internet about insomnia and came across Insomnia Coach and decided to read up on it, hence now am here. My worries and concerns is that when I finally come of the Amitriptyline, will I be able to get a good night’s rest or will I need to go back on another pill. Will my sleep pattern come back or will I struggle to fall asleep each and every night for the rest of my life. I hope that will not be the case.

[Scott]

Hey orellanoc, thanks for sharing your story. Congratulations on finding, implementing and having some success with cognitive and behavioral theory. I truly believe you’re headed in the right direction in overcoming your struggles with falling asleep. When I experienced insomnia, I too had anxious thoughts about falling asleep (and staying asleep) but remained consistent in the same steps you outline and successfully restored my sleep.

It sounds like your sleep has improved since being introduced to those evidence-based techniques too. Why do you think you’ll have a continuation of issues after you taper off of your medication even though you’re seeing positive results with your current plan?

Scott

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If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.

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.

[orellanoc]

Hi Scott,

Glad to hear from you and to know that CBT has helped you to successfully restore your sleep. Well there are days when I don’t sleep too well but to be honest I have more “good” days than bad days. This happens when I would reduce the mg of my medication but tend to improve overtime. At this moment am at 12.5 mg and most nights sleeping fine given I have introduced CBT only based on what I have read but often times I wonder whether my sleep is as a result of the medication or the CBT. I tried to taper off a year ago and was succeasful and was sleeping fine for about 2 weeks but after my insomnia came back. Believe this was part of the withdrawal side effect. At that time I was not doing the CBT so I went back on my medication. Am now ready to taper off again and it’s going good but that’s my only concern but I guess I will only know if I try. Do you believe it’s a good idea to do CBT even though am on medication and tapering off slowly?

[Scott]

Hi orellanoc! I think it’s important to remember that everyone has a bad night of sleep occasionally but it’s how we respond to that restless night that can be a determining factor of long term effects. There are times when that occurs with me and, I too, will wonder if my insomnia is returning but I rely on the evidence-based techniques I learned and you’re now applying for confidence in moving past it.

Any effort we make to force sleep or improve the quality of our sleep is mostly going to be fruitless. It sounds like you have an educated plan and are already seeing positive results from it though – wonderful job!

Scott

—

If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.

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.

[Chee2308]

Sleep will come no matter what you take, or don’t take or are tapering off whatever meds, as long as you go on for long enough without it. If you increase your wake time, your sleep drive increase in proportion until it becomes so high it overrides everything else and you just go to sleep regardless of what you have taking. Just don’t try to sleep inside a lion’s den or inside a sauna with the thermostat turned up to max and you should be able to sleep if you accumulate a large enough sleep drive.

[orellanoc]

Thanks for your feedback and I will keep this in mind. It’s good to know that with a large enough sleep drive, I will definitely be able to fall asleep and overtime my sleep will improve. I was just wondering because there has been times when I would go for about five (5) to seven (7) days with extremely bad sleep and feel so horrible the next day. Overtime my sleep/wake will improve.

[orellanoc]

Thanks Scott and I do agree that it’s the way we deal or respond to that restless will determine the outcome for the longterm. Lastnight I had an extremely bad night however I am determined to stay on track with what I have learnt in regards to CBT.

[Martin Reed]

You’re definitely on the right track, orellanoc!

Ultimately, when we have been awake for long enough we will always sleep. Arousal can temporarily suppress sleepiness and make it harder to fall asleep — but, even then, we will always fall asleep sooner or later.

So, it sounds as though your goal is to make falling asleep easier and more predictable — and you can help reach this goal by ensuring that you are sleepy enough for sleep when you go to bed (sleepy is not the same as tired/exhausted!) and lowering arousal.

It sounds as though you’re doing well on the sleep drive front since you are only going to bed when sleepy (do you still have an earliest possible bedtime?). So, you might find it helpful to work on lowering arousal, too.

There are a few different ways we can lower arousal — we can simply get out of bed whenever being in bed doesn’t feel good and do something more pleasant until conditions feel right for sleep, we can engage in enjoyable daytime activities to give our mind something to focus on other than sleep, and we can explore the sleep-related thoughts that seem to generate worry and anxiety (since they are often not as accurate as they seem when we first have them).

Ultimately, no pill can generate sleep — the only thing that can generate sleep is your own biological sleep drive. Pills can generate sedation, or they can lower arousal, but they cannot generate sleep. So, any sleep you’ve been getting (even when taking pills) is sleep you have generated!

Furthermore, with enough time awake we will always sleep — so we certainly do not need a pill (or anything other than enough time awake) to generate sleep!

I hope this helps.

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If you are ready to stop struggling with insomnia you can enroll in the online insomnia coaching course right now! If you would prefer ongoing phone or video coaching calls as part of a powerful three month program that will help you reclaim your life from insomnia, consider applying for the Insomnia Mastery program.

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.

[orellanoc]

Hi Martin,
Thanks for the encouragement and yes my earliest time would be 10:30 p.m. or 11:00 p.m. but sometimes I don’t get really sleepy until late and when I do feel like sleeping, I get sleep anxiety which as trying to control with deep breathing exercse. I hope that with practice and consistency, my sleep improves in due time.

Cindy

[Author]

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