[Steve]

Hi. I’m new to the forum and have had insomnia since the beginning of November of 2018. Don’t know what brought it on. Doctors say stress and threw all sorts of anti-depressants at me, none of which I really wanted to take since they can be tough getting off of. Some others I tried but they stopped working after a short while. The insomnia got worse until the end of January of this year when I went four days on one hour’s sleep. That brings me to my question. I’ve noticed that some people say you should practice SR (sleep restriction I’m guessing?) without pills because at some point, the body will be so tired you will have to sleep, at least some. When I went four days on one hour’s sleep, I still didn’t feel sleepy, just really fatigued. The only thing that got me some rest was one of those pills I was prescribed. Are you saying eventually, I would have fallen to sleep at some point without the pill even if it went into day six or seven with no sleep?

Another question I had was on CBT-i where it says to get out of bed if you aren’t sleepy and don’t get back into it until you do feel sleepy. But I have had nights where that would mean I am up all night as I never feel sleepy. What time is okay to get back into bed even if you can’t sleep?

I have followed the ACT I conversation with interest and will order the book tonight. I start CBT-i training with a counselor next week. I hope either helps.

[Martin Reed]

Hello Steve and welcome to the forum.

CBT-I techniques are effective for people with chronic insomnia who take sleeping pills and they are effective for people with chronic insomnia who do not take sleeping pills.

To answer your question, yes — eventually you would have fallen asleep without pills. That’s because nobody can stay awake without sleeping at some point. Sleeping is a bit like breathing. Just as we can hold our breath, we can temporarily suspend sleep (usually due to worry about sleep). However, eventually, the body will take over and force us to sleep, just as it will take over and force us to breathe.

If you aren’t sleepy, then you probably aren’t going to sleep. However, it’s important to bear in mind that it is very easy to forget the cues of sleepiness when you have been living with insomnia for a long time and you have very high levels of arousal.

You might find this quick video I recently recorded to be helpful (check out the comments section, too):

https://www.youtube.com/watch?v=UjWdsuOsTt0

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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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