[Sleepymedicalstudent]

Hi, I’m a medical student who struggles with chronic insomnia. My part-time job as a nurse at the hospital (24hour shifts) does not help.
On a regular night with no early school or work tomorrow, I fall asleep very well and sleep for 9 hours if not more. But the problem starts when I have something to do in the morning and I know that there is no way I will be able to sleep in.
The thing is, I usually do not get sleepy until 11pm and sometimes even at that time I’m not tired at all. The days I am free from school or work I do not have problem just waiting till I’m sleepy and then go to bed, but the days I have an early morning, I start to count hours. I know that a normal person needs to have at least 7 hours of sleep, and as a medical student I also know how much sleep can affect our mental and physical health. I have even notices dark circles, more pimples and droopy face after my worst weeks. So… If I go to bed and I only have 7 hours left before my alarm rings, I start to have anxiety about falling asleep which leads to no nights sleep, usually I get so hung up that I do not sleep at all. Just run around the house while crying and not understanding what is wrong with me. I have tried limiting my access to time, but when I am tossing and turning for a long time I get so frustrated guessing what time it is, that I end up watching it either way. Usually, if I see that I havent been able to fall asleep for a few hours my anxiety goes through the roof.
The night shifts- usually(if i don’t have new patients) I am able to sleep for 5 or 6 hours during work, which would be totally ok, if I would be able to actually fall asleep at work. But it is way below 7 hours so automatically my anxiety, again, goes through the roof. The worst part is that I am full time medical student and almost every day after my shifts I have a full day of lectures and work, which is awful, I get nausea and my head hurts almost every day after no nights sleep.
I have tried meditating, changing my thoughts, getting out of bed when i can’t fall asleep but usually end up back where I started from- OK if I don’t have to wake up early but miserable if I do. I always prioritize my sleep and it has become a real problem.
I am writing here to maybe find someone or some help from someone that knows a way to stop focusing on how many hours I get to sleep, on how much it affects my appearance and health. It is just that I have convinced myself that sleep is so important and that I will actually develop some incurable disease if I continue doing this- it has been a long time since I had a normal week or month of sleep.

[spunkyspangler]

hi sleepy med student,

read your post. here is my take on what u have said and just my observations.

1. u stated that “normal” people need at least 7 hours of sleep, so where did u get that “fact” from ????
2. on days that u dont have to go to school or work u are fine so that tells me that your sleep drive is absolutely working just fine, everything as it should be nothing wrong with u
3. days that u have to work the next morning is when u start to go into hyper arousal, worry, clock watch. the mind interprets as a threat cus of all the adrenaline and cortosol in your body and wants to keep u awake to keep u safe, that’s it JOB !!!
4. i am betting that u have not done a sleep window routine and also betting that u have not done stimulus control.
5. clock watching only makes u do sleepeee poooo math, look at the clock 7 hours left, toss and turn, look at the clock 6 hours left yada yada. that stress of looking at the clock only makes the brain work overtime to keep u safe from this threat ( wakefullness). and thus there is no way u are going to sleep.
6. u stated that 5 – 6 way below the 7, so i ask u this, would u rather have 0 hours or 5 times that or 6 times that, i know which one i would take LOL

here is what i would do if i were in this situation.

1. i would set a sleep window for 6 to 6 1/2 hours,
2. i would set an earliest possible bed time
3. i would set the alarm clock and no matter what i would get up at that exact same time every day including the weekends and days that u dont have to go to school etc
4. i would ban all clocks in the bedroom except to turn them around for your alarm.
5. if i could not sleep due to the anxiety then i would leave the bed and go do something that is just a better alternative that tossing and turning, that serves up insomnia even more due to the brain kicking in extra hard to help keep u safe !!

right now from what i read some days u sleep 9 hours some days not so much or get it where u can. your body has not adjusted cus it has no idea of what it is in rythim with.

also, i never ever look at my clock when i shut it down for my sleep window. i dont care what the time is as looking at a clock only increases the sleep math causing more stress.

anyway hope that helps and remember in the beginning there will be short term pain, but the end result will be long term gain !!

spunky

[Sleepymedicalstudent]

Hi , Spunky. Everything you said sounds perfect on paper and I maybe could get used to not using clocks, but the sleep window thing. I am already anxious reading it 😀 I am not able to fall asleep if I have 7 hours left because I worry about my health. 6 is even worse. Also, I am learning more and more about sleep cycles and have noticed many changes in my body if I sleep less than 8 hours, including how I look- I’m young and I really don’t wat to speed up my aging process..
I am too worried about my health because of how much sleep I get and I feel much better if I catch up on my “sleep dept”. All the medical reports,for example, this one https://www.sleepfoundation.org/how-sleep-works/sleep-debt-and-catch-up-sleep tells me that it is very bad to restrict sleep. I would not believe this article if the references would not be the same that we use in med school for patient treatment and studies… 🙁 Med school sometimes is a curse if you actually understant the physiology…

[spunkyspangler]

i hear what u are saying, with my insomnia, i was like u i could get sleep for 8 hours no problem at all. then the trigger happened a few months back and at first i could not sleep at all for the entire night.

got so bad that i researched and found CBTI. i think u should look at it from the other side of the coin in that with sleep windows u are not restricting sleep what we are doing is restricting the time of wakefulness

this shortened window at first is more to alien the body with what u are currently getting for sleep. they say never have it under 5 – 5 1/2 hours, so when i did my sleep window i went with 6 hours 11 pm to 5 am. i think u should remember that this is NOT a permanent thing it is just to get your body in a pattern of sleep. once set in then u can expand that window etc etc

i see that u are really hung up on this i must get 7 hours, then perhaps set a sleep window for say 7 hrs and 15 minutes, that may calm your mind around the obsession

i myself am going through my sleep window and it is not easy as u know. this morning i had
sleep interupted by waking during the middle of the night but found since i dont have any clocks that i can check i have no idea what time it was. so i just layed there and relaxed and sleep visited me again until my alarm went off. when it went off did i want to get up, hell no !! but this in my opinion is a short term pain thing to establish a long term gain. already i see improvements in my situation.

hope this helps u

spunky

[Scott]

Hello!

The amount of sleep we need is subjective and the idea that everyone needs 7-8 hours of sleep is like saying everyone wears a size 10 shoe. The best gauge for the amount of sleep you need is how you feel the next morning from sleep. In my personal experience, I typically sleep anywhere between 6 to 9 hours on any given night. However, regardless of whether I’ve had 6 hours or 9 hours of sleep, I approach the following days with the same level of attention and care to me and my values.

Spunky has some valuable insights that you might want to explore.

When you start feeling anxious about the possibility of getting minimal sleep because of school or work commitments, how do you respond to those thoughts? Do you sense that you might be placing excessive pressure on yourself to sleep during those nights? Have you ever considered what would occur if you approached those nights with the same mindset as those when your schedule isn’t as demanding?

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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.

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