[Noelle]

Hello everyone.

I’ve been suffering from insomnia since February 2017 and have only just now begun Cognitive Behavioural Therapy (CBTI). Since I’m new to CBTI, I feel I need to manage my expectations a bit. It costs a lot of money (€130 per session), and my insurance doesn’t cover it, so it is quite a big investment and commitment for me.

Like many people with insomnia, I obsess over doing everything “right” during the day so that I can make myself fall asleep at night. I know this has to change. I’ve just recently had a brutal 8-day relapse of insomnia (averaging 2 – 3.5 hours per night of sleep) and even though I haven’t completely lost hope, I am so emotionally and physically exhausted by the helplessness I feel to do anything about this. I don’t want to rely on the psychologist or the therapy too much either, but I am truly hoping this will help me to see some tangible and sustainable results well before the end of this year.

Could anyone with experience in CBTI offer any insight or suggestions? I would really appreciate it.

Noelle

[Scott]

Noelle,

Those relapses can be discouraging but they’re part of the process. The only way to permanently regress is if you abandon the CBT-I techniques all together. Consistently implementing the techniques and having patience are, in my opinion, the two most important elements of success in restoring your sleep with CBT-I. Even after restoring my sleep with CBT-I 3 years ago, I will occasionally have a tough night of sleep, but knowing that it won’t impact my day is reassuring. How consistent do you feel you are with the techniques (sleep restriction, stimulus control, etc)?

Scott J

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[Noelle]

Thank you for your reply, Scott.

I must admit I’ve only had two sessions of CBTI. I started in mid-February and can only afford to have them every other week since my insurance doesn’t cover it. The psychologist isn’t recommending sleep restriction with me at this point, but we have discussed it. I am leaning closer and closer to this, even though I know it is taxing.

As for consistent waking times, I feel this is out of my control. I can be consistent with what time I get up, but not with what time I wake up. Sometimes it 2:30am and sometimes it’s 5:30am. I do realise the sleep restriction is designed to deal with that inconsistency though, so this may be the missing part of my process right now.

Thank you for reminding me that relapses are part of the process too. I hadn’t really given that much thought. Part of this issue with me is very external- I’m in a foreign country and have been quite isolated since I moved here, and now there is a war going on very close by, and we are getting large numbers of refugees (women and children) in my city. I am an anti-human trafficking activist in the States, and I obsess over this underrepresented reality in the refugee crisis. I am also on the autism spectrum (very late diagnosed), which I’m told can cause severe anxiety in women over issues related to injustice. I can trace the 8-day relapse back to the first time I saw footage of refugees arriving at the Polish and Moldovan borders, and I realised that many of them were going to be trafficked all over Europe.

The CBT is as much about helping me deal with these obsessive thoughts as it is about trying to deal with the sleep disorder. That said, I think you are absolutely right about the discipline required in being consistent with strategies like sleep restriction. I believe I am going to begin doing this myself, even if the therapist hasn’t recommended it yet.

Thanks again!
N

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