Query about occasional use of sleep aids with CBT

Insomnia Forum Insomnia Help Query about occasional use of sleep aids with CBT

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This topic contains 3 replies, has 2 voices, and was last updated by Martin Reed 3 days, 15 hours ago.

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  • #35491

    LCF
    ✘ Not a client

    Because of my current situation, there are nights when I absolutely have to sleep because I have to get my husband to the hospital for his palliative chemo. There is no room for negotiation here. It’s a fair drive and he sometimes needs a lot of help. On no sleep I can’t drive, and my insomnia is at the point where I’m lucky if I get two hours without help. I’m also responsible for all of the grocery shopping, the cooking, and the cleaning.

    I’ve been through all the meds, pharmaceutical and herbal. They all work for a while, then stop. Even my best friend Lorazepam has failed me after 20 years of an on-off relationship! However, I can use Seroquel like a sleeping pill if I only use it a couple of times a week.

    I did a five week CBT last year that was utterly useless. The “therapist” basically spent half an hour parroting my sleep diary back at me and gave me a couple of links to relaxation exercises. By the end of the five weeks I was sleeping less and my anxiety levels were through the roof, and since then I haven’t been able to fall asleep — I used to fall asleep immediately but wake after three or four hours. Now I can’t even do that.

    I can’t commit to a full CBT program right now because of my life situation (and anyway getting out of bed if I don’t sleep starts my heart palpitating and it won’t stop for the rest of the night), but I was hoping that at least using a sleep window would have some benefit. Even if I could get three or four hours with the odd good night via medication I’d be able to function a bit better and be able to provide my husband with more emotional support. He gets terribly depressed thinking that I’ll be sick for the rest of my life, after he’s gone.

    My question is, if I’m using CBT or at least implementing a sleep window, can I still use the Seroquel on the nights I have to sleep, or is that counter-productive? There’s no danger I’ll use it every night because after about 4 nights it poops out and then I feel even worse the next day.

    Any pointers or comments would be appreciated.

    • This topic was modified 1 week, 1 day ago by LCF.
    #35524

    Martin Reed
    ★ Admin

    You’ll very likely find cognitive behavioral therapy for insomnia (CBT-I) techniques helpful regardless of whether you are taking medication or not. So, I would suggest simply taking any medication as it has been prescribed to you by your physician. You certainly shouldn’t make any changes without talking to your physician first.

    The only time sleeping pills can become problematic is if you take the medication contingently — because this can continually erode your sleep confidence and make you believe that you can only sleep if you take a pill. You might find this video helpful: Does cognitive behavioral therapy for insomnia (CBT-I) work if you are taking sleeping pills?

    I hope this helps.

    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.
    #35527

    LCF
    ✘ Not a client

    That is helpful to know since I’m in a bind at the moment. I was pretty sure I was told that last year when I signed up for the CBT course I took here, but then the CBT therapist got very upset if I used them so I thought perhaps I’d been mistaken.

    My goal is to not need medication, although I don’t rule it out entirely. I just don’t want to depend on it all the time. I hate this feeling of being trapped.

    I think what I’ll start with is a 7-hour window and move it back by half hours if I start to sleep a bit better. Right now just the thought of only having 5.5 hours in bed is too much for me to even think about. I get panicky at the thought. Also, I usually go to bed at 10:30 or eleven pm but if I do a seven hour window to start with I’ll go to bed at midnight, so I should be a bit sleepier than I normally am. 7 hours in bed is a lot less than normal for me, too. I often get four hours of sleep over an eight or nine hour period.

    Thanks for the response. I appreciate it.

    #35580

    Martin Reed
    ★ Admin

    You’re very welcome! If you find the idea of jumping straight to a five-and-a-half-hour sleep window a bit intimidating (which is completely understandable) you can indeed make the reduction a bit more gradual and staggered.

    There is evidence to support the effectiveness of such a strategy — it’s known as sleep compression. Here’s a video about it: If sleep restriction for insomnia is too hard, sleep compression can be a good alternative.

    I hope this helps!

    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.
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